Antibiotic stewardship in the pediatric dialysis unit

Antibiotic stewardship has become a key intervention in combating the increasing rates of antibiotic-resistant bacterial infections. By 2050, it is estimated that ten million people worldwide will die annually from an antimicrobial resistant infection if nothing is done to improve the use of antimicrobials. In this chapter, data is presented demonstrating the increasing rates of antibiotic-resistant bacteria identified in children, though data is limited among pediatric dialysis patients. Additionally, the use of antibiotics in dialysis patients is described to be extensive though data is, again, limited among pediatric patients. Finally, antimicrobial stewardship strategies are discussed highlighting the many different potential interventions to improve the use of antimicrobials in children undergoing dialysis. Importantly, more data are needed on which antimicrobial stewardship strategies are effective in improving overall antimicrobial use in this population.