Children's Hospital Colorado

Children’s Colorado Provides Pediatric Guidance to Improve Antimicrobial Stewardship Statewide

Children's Hospital Colorado | November 20, 2023

Last year, Children’s Hospital Colorado’s Antimicrobial Stewardship Program was nationally recognized for playing an important role in optimizing the use of antibiotics for better pediatric patient and hospital outcomes. Now, the Children’s Colorado Antimicrobial Stewardship team, along with teams from Denver Health and the Colorado Department of Public Health and Environment (CDPHE), have partnered with Firstline, a health technology company, to design a mobile version of their infectious disease guidance and deliver it to all healthcare providers in Colorado.

Supporting rural hospitals’ pediatric care

The goal of the partnership is to support hospitals and providers who may not have easy access to a local, comprehensive range of infectious disease guidance. With the mobile application developed through the partnership, providers can quickly access critical information about the pediatric population, especially useful for rural hospitals and facilities that may not have pediatric-specific clinical pathways or diagnostic tools in-house.

The platform includes Children’s Colorado clinical practice guidelines for antimicrobial use, information on antimicrobial dosing for pediatrics, materials and data on pathogens, lab interpretation guidance, first-treatment options, guidance for preventing antibiotic resistance, recommendations for alternative medications if there is a drug shortage, analytic tools and other useful antimicrobial stewardship resources, all with an emphasis on pediatrics.

The infectious disease experts providing innovative guidance

To make this partnership possible, Sarah Parker, MD, Medical Director of Antimicrobial Stewardship at Children’s Colorado, applied for and was awarded the Pfizer Global Bridges Grant that runs through January 2025. Dr. Parker’s motivating factor was to share resources and support with providers, particularly those in rural settings, to help them develop pathways to managing infectious diseases, as well as promote stewardship across the state.

“Kids need incredibly different care, especially in the emergency department setting. We want to help providers be less afraid of diagnosing and treating kids who are seen in emergency rooms or urgent cares, presenting with cases of pneumonia or UTIs, for example. This app provides access to our resources and is available literally in the palm of your hand. It can provide pathogen and dosing information in real time, preventing the need to send out labs or sending patients to facilities located hours away,” said Parker.

A journey towards better health outcomes

“Antimicrobial stewardship, or using the right antibiotic at the right time, is key in the battle against antimicrobial resistance,” said Michael Bozzella, DO, infectious disease specialist at Children’s Colorado. “By focusing our use of antibiotics to the right dose for the right amount of time, we can positively impact the health of our patients and our society.”

The impact of shared clinical pathways on pediatric care

The Antimicrobial Stewardship team at Children’s Colorado has been working with the CDPHE for several years to improve antimicrobial stewardship across the state through an educational outreach program called the Colorado Antimicrobial Stewardship Endeavor (CASE). Prior surveys identified the need for accessible guidance when it comes to pediatric patients, particularly in smaller hospitals that don’t have providers specialized uniquely in children.

“Through CASE, it became apparent that not every hospital has the time and resources to develop their own guidance. Clinical pathways are tools that streamline diagnosis and treatment of common conditions in kids and adults and are key to many efforts in antimicrobial stewardship. This need served as the inspiration for our version of Firstline. In sharing this resource, we aim to impact antibiotic use for the better, and improve the health of everyone in Colorado,” said Bozzella.

Antimicrobial stewardship is important amidst antibiotic shortages

According to Leigh Anne Bakel, MD, Medical Director of Clinical Effectiveness at Children’s Colorado, by implementing the best-practice "handshake" antimicrobial stewardship program at Children’s Colorado, the team has seen a drop in the duration of antibiotics prescribed, which is especially helpful now, given the recent antibiotic shortages.

Testimonials from the front lines of pediatric care

“The application guides us through treatment algorithms and helps us choose the most appropriate antibiotic and correct dosing for each indication. This is especially important at our small rural hospital given our low pediatric patient volume and potential for staff to be less familiar with these patients and treatments,” said, Nancy McClew, PharmD, BCPS, Director of Pharmacy at Grand River Hospital and Medical Center in Rifle, Colo.

The Colorado statewide version of the mobile application was created for the hospital’s seven-state region, where common pathogens are shared, but is also available globally. In Colorado, the team will track the geographic locations where the app is being used to measure whether there is a drop in duration of antibiotics use.

The mobile application is free to download on both the web and mobile, available on the Apple Store and Google Play.