Abstract
The antimicrobial stewardship program (ASP) is an effective strategy for controlling antimicrobial resistance. ASP is important among immunocompromised patients, including cancer patients and hematopoietic cell transplantation (HCT) recipients, because of their high likelihood of receiving broad-spectrum antibiotics. However, the optimal method of ASP for such patients has not been well established, especially for children. We retrospectively reviewed days of therapy (DOTs) of broad-spectrum antibiotics and DOTs/1,000 patient-days in each year from 2012 to 2016 and compared them. The total patient-days and the number of hospitalized patients and HCT recipients tended to increase. The DOTs/1,000 patient-days of carbapenem significantly decreased and remained low (76 to 40). Although the number of prescriptions of antipseudomonal antibiotics and glycopeptide antibiotics increased along with the increase in the total number of cancer patients and HCT recipients, the DOTs/1,000 patient-days significantly decreased and remained low. The cost of broad-spectrum antibiotics was reduced by approximately five million yen annually. The overall mortality and infection-associated mortality did not change. Our ASP strategies applied in collaboration with a pediatric hematology–oncology physician and the ASP team safely minimized the use of broad-spectrum antibiotics.
