A Whole of Country Analysis of Antimicrobial Stewardship Resources, Activities and Barriers for Children in Australian Hospitals Pre- and Post COVID-19

Penelope A Bryant¹, Vanessa Clifford², Brendan McMullan³, Asha C Bowen⁴, Natalie Morgan⁵; ANZPID-ASAP group

Affiliations

¹ Clinical Infections, Murdoch Children's Research Institute, Parkville, VIC, Australia; Infectious Diseases Department, The Royal Children's Hospital, Parkville, VIC, Australia; Department of Paediatrics, University of Melbourne, Parkville, VIC, Australia; Hospital-in-the-Home Department, The Royal Children's Hospital, Parkville, VIC, Australia. Electronic address: Penelope.Bryant@rch.org.au.
² Infectious Diseases Department, The Royal Children's Hospital, Parkville, VIC, Australia; Department of Paediatrics, University of Melbourne, Parkville, VIC, Australia; Infectious Disease, Murdoch Children's Research Institute, Parkville, VIC, Australia; Australian Red Cross Lifeblood, West Melbourne, VIC, Australia.
³ Department of Immunology and Infectious Diseases, Sydney Children's Hospital, Randwick, NSW, Australia; School of Women's and Children's Heath, University of New South Wales, Sydney, NSW, Australia.
⁴ Department of Infectious Diseases, Perth Children's Hospital, WA, Australia; Wesfarmers Centre for Vaccines and Infectious Diseases, Telethon Kids Institute, WA, Australia; Division of Paediatrics, School of Medicine, University of Western Australia, WA, Australia; Menzies School of Health Research, Charles Darwin University, NT, Australia; University of Notre Dame, WA, Australia.
⁵ Clinical Infections, Murdoch Children's Research Institute, Parkville, VIC, Australia.

PMID: 41237984
DOI: 10.1016/j.jhin.2025.10.032

A Whole of Country Analysis of Antimicrobial Stewardship Resources, Activities and Barriers for Children in Australian Hospitals Pre- and Post COVID-19

Penelope A Bryant et al. J Hosp Infect. 2025.

. 2025 Nov 12:S0195-6701(25)00353-6.

doi: 10.1016/j.jhin.2025.10.032. Online ahead of print.

Authors

Penelope A Bryant¹, Vanessa Clifford², Brendan McMullan³, Asha C Bowen⁴, Natalie Morgan⁵; ANZPID-ASAP group

Affiliations

¹ Clinical Infections, Murdoch Children's Research Institute, Parkville, VIC, Australia; Infectious Diseases Department, The Royal Children's Hospital, Parkville, VIC, Australia; Department of Paediatrics, University of Melbourne, Parkville, VIC, Australia; Hospital-in-the-Home Department, The Royal Children's Hospital, Parkville, VIC, Australia. Electronic address: Penelope.Bryant@rch.org.au.
² Infectious Diseases Department, The Royal Children's Hospital, Parkville, VIC, Australia; Department of Paediatrics, University of Melbourne, Parkville, VIC, Australia; Infectious Disease, Murdoch Children's Research Institute, Parkville, VIC, Australia; Australian Red Cross Lifeblood, West Melbourne, VIC, Australia.
³ Department of Immunology and Infectious Diseases, Sydney Children's Hospital, Randwick, NSW, Australia; School of Women's and Children's Heath, University of New South Wales, Sydney, NSW, Australia.
⁴ Department of Infectious Diseases, Perth Children's Hospital, WA, Australia; Wesfarmers Centre for Vaccines and Infectious Diseases, Telethon Kids Institute, WA, Australia; Division of Paediatrics, School of Medicine, University of Western Australia, WA, Australia; Menzies School of Health Research, Charles Darwin University, NT, Australia; University of Notre Dame, WA, Australia.
⁵ Clinical Infections, Murdoch Children's Research Institute, Parkville, VIC, Australia.

PMID: 41237984
DOI: 10.1016/j.jhin.2025.10.032

Abstract

Background: /Aim: We aimed to assess and identify any gaps in antimicrobial stewardship (AMS) resources and activities for all hospitalised children in Australia pre- and post- the COVID-19 pandemic.

Methods: A comprehensive data collection tool adapted from a 2014 study of tertiary paediatric hospitals by the ANZPID-ASAP group, was applied in 2017 and 2024. Every public hospital with paediatric inpatients was included. The most appropriate representative for paediatric AMS at each hospital provided information.

Results: There are 106 hospitals treating children in Australia and data was completed for 100%. Paediatric beds ranged from 3-360, with total 4,142 beds. 17 (35%) tertiary/metropolitan hospitals had paediatric AMS, compared with 5 (9%) regional/rural hospitals (p=0.001). There was an AMS pharmacist in 38 (81%) tertiary/metropolitan compared to 27 (53%) regional/rural hospitals (p=0.003). 51 (48%) hospitals had local paediatric empirical antibiotic guidelines, fewer had specialty guidelines. 102 (96%) hospitals had restrictions on broad-spectrum antimicrobials, though formal approval systems were fewer: 44 (90%) tertiary/metropolitan versus 35 (66%) regional/rural hospitals (p=0.004). AMS education was poor: 25 (24%) hospitals provided education for senior physicians, 24 (23%) had none for any staff. The commonest barriers to successful AMS were lack of infectious diseases and microbiology services (n= 64 (60%)), dedicated pharmacists (n=62 (59%)), and education for clinicians (n=53 (50%)). Little has changed since the COVID-19 pandemic.

Conclusion: There are large gaps in paediatric-specific AMS resources and expertise, particularly in regional and rural hospitals. Increased resourcing, paediatric AMS education for clinicians and improved sharing of guidelines/resources are vital to ensure all hospitalised children receive optimal care.

Keywords: Antimicrobial stewardship; antibiotic resistance; antibiotics; audit; benchmarking.

PubMed Disclaimer

LinkOut - more resources

Full Text Sources
- ClinicalKey
- Elsevier Science

Save citation to file

Email citation

Add to Collections

Add to My Bibliography

Your saved search

Create a file for external citation management software

Your RSS Feed

A Whole of Country Analysis of Antimicrobial Stewardship Resources, Activities and Barriers for Children in Australian Hospitals Pre- and Post COVID-19

Affiliations

A Whole of Country Analysis of Antimicrobial Stewardship Resources, Activities and Barriers for Children in Australian Hospitals Pre- and Post COVID-19

Authors

Affiliations

Abstract

LinkOut - more resources

Full Text Sources