Development and maintenance of consensus recommendations on pediatric outpatient antibiotic therapy in Germany: a framework for rational use

European Journal of Pediatrics – DOI: 10.1007/s00431-024-05964-y

Abstract:

In pediatric outpatient care, overuse and misuse of antibiotics is linked to a high risk of adverse events and increased antibiotic resistance. In 2019, building upon the work of the Antibiotic Therapy in Bielefeld (AnTiB) project (founded in 2016), a collaboration among the AnTiB, the German Society for Pediatric Infectious Diseases (DGPI), and the Professional Association of Outpatient Pediatricians and Adolescent Physicians (BVKJ) was established to develop consensus recommendations for antibiotic therapy in pediatric outpatient settings in Germany. This working group became the Antibiotic Stewardship in Outpatient Pediatrics (ABSaP). ABSaP institutes recommendations for antibiotic use in outpatient pediatric settings in Germany and updates them regularly. The ABSaP guidelines recommend restrictive, targeted, evidence-based prescription practices for antibiotics used to treat common infections among pediatric outpatients. This expert-driven, pragmatic, best-practice guidance is designed to be a living document. ABSaP’s most recent update was published in March 2024. The recommendations aim to guide and standardize rational antibiotics use by emphasizing the importance of avoiding unnecessary prescriptions, while also promoting the application of narrow-spectrum antibiotics, short-duration therapy, and watchful waiting, when treating mild, self-limiting infections in children without significant risk factors.

Conclusions: ABSaP’s guidelines may provide a model for others, as well as offer a basis for discussing practical, effective antibiotic stewardship (ABS) measures in pediatric primary care. An international, expert consensus on ABS for pediatric outpatients could help promote a culture of responsible antibiotic use, improve prescribing safety, and contribute to broader ABS efforts.