Dear HIFA and CHIFA colleagues,
1. Hospitals should provide prescribers with access to current, evidence-based, endorsed antimicrobial guidelines suitable for paediatric patients
2. Hospitals should ensure prescribers have access to expert advice in paediatric infection management.
3. Hospitals should provide access to education on management of common infections in children and AMS for prescribers and other clinicians
These are the first three of 10 recommendations of this new paper in The Lancet Infectious Diseases. Citation, summary and comment from me below.
CITATION: Multinational consensus antimicrobial stewardship recommendations for children managed in hospital settings
Brendan McMullan et al
Published online December 22, 2022 https://doi.org/10.1016/S1473-3099(22)00726-5
SUMMARY: Children are entitled to receive antibiotic therapy that is based on evidence and best practice, but might be overlooked in hospital programmes designed to achieve antimicrobial stewardship [AMS]. This failure to include children could be because children make up small proportion of patients in most hospitals, and are cared for by specialised paediatric staff. We reviewed the evidence and consulted experts in three global regions to develop ten recommendations for good-practice in hospital AMS programmes for children. We performed a review of scientific research, published between Jan 1, 2007, and Oct 17, 2019, concerning AMS, and formed a multinational expert group comprising members from the USA, Canada, the UK, Belgium, Switzerland, Australia, and Aotearoa New Zealand to develop the recommendations. These recommendations aim to help health-care workers who care for children in these regions to deliver best-practice care. We surveyed health-care workers with expertise in antibiotic therapy for children across these regions, and found that the recommendations were considered both very important and generally feasible. These recommendations should be implemented in hospitals to improve antibiotic therapy for children and to stimulate research into future improvements in care.
COMMENT (NPW): Regarding #1 it is an indictment of the global health community (and national health systems) that frontline health workers do not currently have access to current, evidence-based, endorsed antimicrobial guidelines suitable for paediatric patients. Regarding #2 it is an indictment of the global health community (and national health systems) that frontline health workers do not currently have access to expert advice in paediatric infection management (such advice, if not locally available, should be accessible virtually). Ten years ago, WHO reported that ‘Globally, most prescribers receive most of their prescribing information from the pharmaceutical industry and in many countries this is the only information they receive.’ It is an indictment of the global health community that the current situation is not demonstrably improved. The HIFA project to improve access to reliable information for prescribers and users of medicines published a systematic review in 2020 that concluded there is 'a lack of up- to- date and relevant medicine information in low and lower middle- income settings'. https://www.hifa.org/news/hifas-first-systematic-review-how-primary-heal...
It has been estimated that antimicrobial resistance, driven largely by inappropriate use of antibiotics, will cause hundreds of millions of premature deaths in the coming decades and $100 trillion in costs. This monumental burden of suffering is largely driven by a lack of access to reliable information among prescribers and users of antibiotics (and other medicines). A global action plan to improve the availability of reliable healthcare information is clearly needed. HIFA aims to build on our achievements 2006-2022 [ https://www.hifa.org/achievements ] through a global consultation in 2023: 'To identify best practices, opportunities and challenges from relevant health related stakeholders, towards pursuing universal access to reliable healthcare information'. This will be delivered to WHO by the end of 2023 as part of our commitment in official relation. We are counting on individual members and supporting organisations to participate.
Best wishes, Neil
Dr Neil Pakenham-Walsh, HIFA Coordinator
Healthcare Information For All
Global Healthcare Information Network
Working in Official Relations with the World Health Organization
20,000 members, 400 supporting organisations, 180 countries, 6 forums, 4 languages. www.hifa.org firstname.lastname@example.org