Improving Antibiotic Use in Argentine Pediatric Hospitals: A Process Evaluation Using Normalization Process Theory

Autores
Roberti, Javier Eugenio; Jorro Barón, Facundo; Ini, Natali Denise; Guglielmino, Marina; Rodríguez, Ana Paula; Echave, Cecilia; Falaschi, Andrea; Rodríguez, Viviana E.; García Elorrio, Ezequiel; Alonso, Juan Pedro
Año de publicación
2025
Idioma
inglés
Tipo de recurso
artículo
Estado
versión publicada
Descripción
Introduction: In the pediatric setting, overprescribing of antibiotics contributes to the rise of multidrug-resistant organisms. Antimicrobial stewardship programs (ASPs) are recommended to optimize antibiotic use and combat resistance. However, the implementation of ASPs in low- and middle-income countries faces several challenges. This study aimed to evaluate the implementation process of a multifaceted ASP in 2 pediatric hospitals in Argentina.Methods: A qualitative study was conducted in two large public children’s hospitals in Argentina, using semistructured interviews with 32 healthcare providers at the beginning and end of the ASP implementation. The study was guided by the normalization process theory.Results: The intervention faced challenges, including limited understanding of its objectives, confusion with existing practices, and insufficient commitment from senior staff. Although junior staff were more receptive, communication barriers with external staff and workload concerns hindered broader adoption. Infectious disease specialists primarily led implementation, with limited involvement of other staff, particularly in training activities. Despite these challenges, participants reported improvements, such as the development of standardized antibiotic guidelines, better interdisciplinary collaboration, and improved communication. However, organizational support and resistance to new practices remained barriers.Conclusions: This study highlights the importance of organizational context and staff commitment in ASP implementation. Tailored strategies that address the specific challenges of low- and middle-income countries are needed to effectively implement ASPs.
Fil: Roberti, Javier Eugenio. Consejo Nacional de Investigaciones Científicas y Técnicas. Oficina de Coordinación Administrativa Parque Centenario. Centro de Investigaciones en Epidemiología y Salud Pública. Instituto de Efectividad Clínica y Sanitaria. Centro de Investigaciones en Epidemiología y Salud Pública; Argentina
Fil: Jorro Barón, Facundo. Instituto de Efectividad Clínica y Sanitaria; Argentina
Fil: Ini, Natali Denise. Consejo Nacional de Investigaciones Científicas y Técnicas. Oficina de Coordinación Administrativa Parque Centenario. Centro de Investigaciones en Epidemiología y Salud Pública. Instituto de Efectividad Clínica y Sanitaria. Centro de Investigaciones en Epidemiología y Salud Pública; Argentina
Fil: Guglielmino, Marina. Instituto de Efectividad Clínica y Sanitaria; Argentina
Fil: Rodríguez, Ana Paula. Instituto de Efectividad Clínica y Sanitaria; Argentina
Fil: Echave, Cecilia. Gobierno de la Ciudad de Buenos Aires. Hospital General de Niños Pedro Elizalde (ex Casa Cuna); Argentina
Fil: Falaschi, Andrea. Hospital Pediatrico Humberto Notti ; Gobierno de la Provincia de Mendoza;
Fil: Rodríguez, Viviana E.. Instituto de Efectividad Clínica y Sanitaria; Argentina
Fil: García Elorrio, Ezequiel. Instituto de Efectividad Clínica y Sanitaria; Argentina
Fil: Alonso, Juan Pedro. Consejo Nacional de Investigaciones Científicas y Técnicas; Argentina. Universidad de Buenos Aires. Facultad de Ciencias Sociales. Instituto de Investigaciones "Gino Germani"; Argentina
Materia
ANTIBIOTICS RESISTANCE
HOSPITAL
PEDIATRICS
NORMALIZATION PROCESS THEORY
Nivel de accesibilidad
acceso abierto
Condiciones de uso
https://creativecommons.org/licenses/by-nc-sa/2.5/ar/
Repositorio
CONICET Digital (CONICET)
Institución
Consejo Nacional de Investigaciones Científicas y Técnicas
OAI Identificador
oai:ri.conicet.gov.ar:11336/266153
Acceder
id CONICETDig_39097a47377202d27f1301ddba1af908
oai_identifier_str oai:ri.conicet.gov.ar:11336/266153
network_acronym_str CONICETDig
repository_id_str 3498
network_name_str CONICET Digital (CONICET)
spelling Improving Antibiotic Use in Argentine Pediatric Hospitals: A Process Evaluation Using Normalization Process TheoryRoberti, Javier EugenioJorro Barón, FacundoIni, Natali DeniseGuglielmino, MarinaRodríguez, Ana PaulaEchave, CeciliaFalaschi, AndreaRodríguez, Viviana E.García Elorrio, EzequielAlonso, Juan PedroANTIBIOTICS RESISTANCEHOSPITALPEDIATRICSNORMALIZATION PROCESS THEORYhttps://purl.org/becyt/ford/3.2https://purl.org/becyt/ford/3Introduction: In the pediatric setting, overprescribing of antibiotics contributes to the rise of multidrug-resistant organisms. Antimicrobial stewardship programs (ASPs) are recommended to optimize antibiotic use and combat resistance. However, the implementation of ASPs in low- and middle-income countries faces several challenges. This study aimed to evaluate the implementation process of a multifaceted ASP in 2 pediatric hospitals in Argentina.Methods: A qualitative study was conducted in two large public children’s hospitals in Argentina, using semistructured interviews with 32 healthcare providers at the beginning and end of the ASP implementation. The study was guided by the normalization process theory.Results: The intervention faced challenges, including limited understanding of its objectives, confusion with existing practices, and insufficient commitment from senior staff. Although junior staff were more receptive, communication barriers with external staff and workload concerns hindered broader adoption. Infectious disease specialists primarily led implementation, with limited involvement of other staff, particularly in training activities. Despite these challenges, participants reported improvements, such as the development of standardized antibiotic guidelines, better interdisciplinary collaboration, and improved communication. However, organizational support and resistance to new practices remained barriers.Conclusions: This study highlights the importance of organizational context and staff commitment in ASP implementation. Tailored strategies that address the specific challenges of low- and middle-income countries are needed to effectively implement ASPs.Fil: Roberti, Javier Eugenio. Consejo Nacional de Investigaciones Científicas y Técnicas. Oficina de Coordinación Administrativa Parque Centenario. Centro de Investigaciones en Epidemiología y Salud Pública. Instituto de Efectividad Clínica y Sanitaria. Centro de Investigaciones en Epidemiología y Salud Pública; ArgentinaFil: Jorro Barón, Facundo. Instituto de Efectividad Clínica y Sanitaria; ArgentinaFil: Ini, Natali Denise. Consejo Nacional de Investigaciones Científicas y Técnicas. Oficina de Coordinación Administrativa Parque Centenario. Centro de Investigaciones en Epidemiología y Salud Pública. Instituto de Efectividad Clínica y Sanitaria. Centro de Investigaciones en Epidemiología y Salud Pública; ArgentinaFil: Guglielmino, Marina. Instituto de Efectividad Clínica y Sanitaria; ArgentinaFil: Rodríguez, Ana Paula. Instituto de Efectividad Clínica y Sanitaria; ArgentinaFil: Echave, Cecilia. Gobierno de la Ciudad de Buenos Aires. Hospital General de Niños Pedro Elizalde (ex Casa Cuna); ArgentinaFil: Falaschi, Andrea. Hospital Pediatrico Humberto Notti ; Gobierno de la Provincia de Mendoza;Fil: Rodríguez, Viviana E.. Instituto de Efectividad Clínica y Sanitaria; ArgentinaFil: García Elorrio, Ezequiel. Instituto de Efectividad Clínica y Sanitaria; ArgentinaFil: Alonso, Juan Pedro. Consejo Nacional de Investigaciones Científicas y Técnicas; Argentina. Universidad de Buenos Aires. Facultad de Ciencias Sociales. Instituto de Investigaciones "Gino Germani"; ArgentinaLippincott Williams2025-01info:eu-repo/semantics/articleinfo:eu-repo/semantics/publishedVersionhttp://purl.org/coar/resource_type/c_6501info:ar-repo/semantics/articuloapplication/pdfapplication/pdfapplication/pdfhttp://hdl.handle.net/11336/266153Roberti, Javier Eugenio; Jorro Barón, Facundo; Ini, Natali Denise; Guglielmino, Marina; Rodríguez, Ana Paula; et al.; Improving Antibiotic Use in Argentine Pediatric Hospitals: A Process Evaluation Using Normalization Process Theory; Lippincott Williams; Pediatric Quality & Safety; 10; 1; 1-2025; 1-72472-0054CONICET DigitalCONICETenginfo:eu-repo/semantics/altIdentifier/url/https://journals.lww.com/10.1097/pq9.0000000000000788info:eu-repo/semantics/altIdentifier/doi/10.1097/pq9.0000000000000788info:eu-repo/semantics/openAccesshttps://creativecommons.org/licenses/by-nc-sa/2.5/ar/reponame:CONICET Digital (CONICET)instname:Consejo Nacional de Investigaciones Científicas y Técnicas2025-10-22T11:57:39Zoai:ri.conicet.gov.ar:11336/266153instacron:CONICETInstitucionalhttp://ri.conicet.gov.ar/Organismo científico-tecnológicoNo correspondehttp://ri.conicet.gov.ar/oai/requestdasensio@conicet.gov.ar; lcarlino@conicet.gov.arArgentinaNo correspondeNo correspondeNo correspondeopendoar:34982025-10-22 11:57:39.659CONICET Digital (CONICET) - Consejo Nacional de Investigaciones Científicas y Técnicasfalse
dc.title.none.fl_str_mv Improving Antibiotic Use in Argentine Pediatric Hospitals: A Process Evaluation Using Normalization Process Theory
title Improving Antibiotic Use in Argentine Pediatric Hospitals: A Process Evaluation Using Normalization Process Theory
spellingShingle Improving Antibiotic Use in Argentine Pediatric Hospitals: A Process Evaluation Using Normalization Process Theory
Roberti, Javier Eugenio
ANTIBIOTICS RESISTANCE
HOSPITAL
PEDIATRICS
NORMALIZATION PROCESS THEORY
title_short Improving Antibiotic Use in Argentine Pediatric Hospitals: A Process Evaluation Using Normalization Process Theory
title_full Improving Antibiotic Use in Argentine Pediatric Hospitals: A Process Evaluation Using Normalization Process Theory
title_fullStr Improving Antibiotic Use in Argentine Pediatric Hospitals: A Process Evaluation Using Normalization Process Theory
title_full_unstemmed Improving Antibiotic Use in Argentine Pediatric Hospitals: A Process Evaluation Using Normalization Process Theory
title_sort Improving Antibiotic Use in Argentine Pediatric Hospitals: A Process Evaluation Using Normalization Process Theory
dc.creator.none.fl_str_mv Roberti, Javier Eugenio
Jorro Barón, Facundo
Ini, Natali Denise
Guglielmino, Marina
Rodríguez, Ana Paula
Echave, Cecilia
Falaschi, Andrea
Rodríguez, Viviana E.
García Elorrio, Ezequiel
Alonso, Juan Pedro
author Roberti, Javier Eugenio
author_facet Roberti, Javier Eugenio
Jorro Barón, Facundo
Ini, Natali Denise
Guglielmino, Marina
Rodríguez, Ana Paula
Echave, Cecilia
Falaschi, Andrea
Rodríguez, Viviana E.
García Elorrio, Ezequiel
Alonso, Juan Pedro
author_role author
author2 Jorro Barón, Facundo
Ini, Natali Denise
Guglielmino, Marina
Rodríguez, Ana Paula
Echave, Cecilia
Falaschi, Andrea
Rodríguez, Viviana E.
García Elorrio, Ezequiel
Alonso, Juan Pedro
author2_role author
author
author
author
author
author
author
author
author
dc.subject.none.fl_str_mv ANTIBIOTICS RESISTANCE
HOSPITAL
PEDIATRICS
NORMALIZATION PROCESS THEORY
topic ANTIBIOTICS RESISTANCE
HOSPITAL
PEDIATRICS
NORMALIZATION PROCESS THEORY
purl_subject.fl_str_mv https://purl.org/becyt/ford/3.2
https://purl.org/becyt/ford/3
dc.description.none.fl_txt_mv Introduction: In the pediatric setting, overprescribing of antibiotics contributes to the rise of multidrug-resistant organisms. Antimicrobial stewardship programs (ASPs) are recommended to optimize antibiotic use and combat resistance. However, the implementation of ASPs in low- and middle-income countries faces several challenges. This study aimed to evaluate the implementation process of a multifaceted ASP in 2 pediatric hospitals in Argentina.Methods: A qualitative study was conducted in two large public children’s hospitals in Argentina, using semistructured interviews with 32 healthcare providers at the beginning and end of the ASP implementation. The study was guided by the normalization process theory.Results: The intervention faced challenges, including limited understanding of its objectives, confusion with existing practices, and insufficient commitment from senior staff. Although junior staff were more receptive, communication barriers with external staff and workload concerns hindered broader adoption. Infectious disease specialists primarily led implementation, with limited involvement of other staff, particularly in training activities. Despite these challenges, participants reported improvements, such as the development of standardized antibiotic guidelines, better interdisciplinary collaboration, and improved communication. However, organizational support and resistance to new practices remained barriers.Conclusions: This study highlights the importance of organizational context and staff commitment in ASP implementation. Tailored strategies that address the specific challenges of low- and middle-income countries are needed to effectively implement ASPs.
Fil: Roberti, Javier Eugenio. Consejo Nacional de Investigaciones Científicas y Técnicas. Oficina de Coordinación Administrativa Parque Centenario. Centro de Investigaciones en Epidemiología y Salud Pública. Instituto de Efectividad Clínica y Sanitaria. Centro de Investigaciones en Epidemiología y Salud Pública; Argentina
Fil: Jorro Barón, Facundo. Instituto de Efectividad Clínica y Sanitaria; Argentina
Fil: Ini, Natali Denise. Consejo Nacional de Investigaciones Científicas y Técnicas. Oficina de Coordinación Administrativa Parque Centenario. Centro de Investigaciones en Epidemiología y Salud Pública. Instituto de Efectividad Clínica y Sanitaria. Centro de Investigaciones en Epidemiología y Salud Pública; Argentina
Fil: Guglielmino, Marina. Instituto de Efectividad Clínica y Sanitaria; Argentina
Fil: Rodríguez, Ana Paula. Instituto de Efectividad Clínica y Sanitaria; Argentina
Fil: Echave, Cecilia. Gobierno de la Ciudad de Buenos Aires. Hospital General de Niños Pedro Elizalde (ex Casa Cuna); Argentina
Fil: Falaschi, Andrea. Hospital Pediatrico Humberto Notti ; Gobierno de la Provincia de Mendoza;
Fil: Rodríguez, Viviana E.. Instituto de Efectividad Clínica y Sanitaria; Argentina
Fil: García Elorrio, Ezequiel. Instituto de Efectividad Clínica y Sanitaria; Argentina
Fil: Alonso, Juan Pedro. Consejo Nacional de Investigaciones Científicas y Técnicas; Argentina. Universidad de Buenos Aires. Facultad de Ciencias Sociales. Instituto de Investigaciones "Gino Germani"; Argentina
description Introduction: In the pediatric setting, overprescribing of antibiotics contributes to the rise of multidrug-resistant organisms. Antimicrobial stewardship programs (ASPs) are recommended to optimize antibiotic use and combat resistance. However, the implementation of ASPs in low- and middle-income countries faces several challenges. This study aimed to evaluate the implementation process of a multifaceted ASP in 2 pediatric hospitals in Argentina.Methods: A qualitative study was conducted in two large public children’s hospitals in Argentina, using semistructured interviews with 32 healthcare providers at the beginning and end of the ASP implementation. The study was guided by the normalization process theory.Results: The intervention faced challenges, including limited understanding of its objectives, confusion with existing practices, and insufficient commitment from senior staff. Although junior staff were more receptive, communication barriers with external staff and workload concerns hindered broader adoption. Infectious disease specialists primarily led implementation, with limited involvement of other staff, particularly in training activities. Despite these challenges, participants reported improvements, such as the development of standardized antibiotic guidelines, better interdisciplinary collaboration, and improved communication. However, organizational support and resistance to new practices remained barriers.Conclusions: This study highlights the importance of organizational context and staff commitment in ASP implementation. Tailored strategies that address the specific challenges of low- and middle-income countries are needed to effectively implement ASPs.
publishDate 2025
dc.date.none.fl_str_mv 2025-01
dc.type.none.fl_str_mv info:eu-repo/semantics/article
info:eu-repo/semantics/publishedVersion
http://purl.org/coar/resource_type/c_6501
info:ar-repo/semantics/articulo
format article
status_str publishedVersion
dc.identifier.none.fl_str_mv http://hdl.handle.net/11336/266153
Roberti, Javier Eugenio; Jorro Barón, Facundo; Ini, Natali Denise; Guglielmino, Marina; Rodríguez, Ana Paula; et al.; Improving Antibiotic Use in Argentine Pediatric Hospitals: A Process Evaluation Using Normalization Process Theory; Lippincott Williams; Pediatric Quality & Safety; 10; 1; 1-2025; 1-7
2472-0054
CONICET Digital
CONICET
url http://hdl.handle.net/11336/266153
identifier_str_mv Roberti, Javier Eugenio; Jorro Barón, Facundo; Ini, Natali Denise; Guglielmino, Marina; Rodríguez, Ana Paula; et al.; Improving Antibiotic Use in Argentine Pediatric Hospitals: A Process Evaluation Using Normalization Process Theory; Lippincott Williams; Pediatric Quality & Safety; 10; 1; 1-2025; 1-7
2472-0054
CONICET Digital
CONICET
dc.language.none.fl_str_mv eng
language eng
dc.relation.none.fl_str_mv info:eu-repo/semantics/altIdentifier/url/https://journals.lww.com/10.1097/pq9.0000000000000788
info:eu-repo/semantics/altIdentifier/doi/10.1097/pq9.0000000000000788
dc.rights.none.fl_str_mv info:eu-repo/semantics/openAccess
https://creativecommons.org/licenses/by-nc-sa/2.5/ar/
eu_rights_str_mv openAccess
rights_invalid_str_mv https://creativecommons.org/licenses/by-nc-sa/2.5/ar/
dc.format.none.fl_str_mv application/pdf
application/pdf
application/pdf
dc.publisher.none.fl_str_mv Lippincott Williams
publisher.none.fl_str_mv Lippincott Williams
dc.source.none.fl_str_mv reponame:CONICET Digital (CONICET)
instname:Consejo Nacional de Investigaciones Científicas y Técnicas
reponame_str CONICET Digital (CONICET)
collection CONICET Digital (CONICET)
instname_str Consejo Nacional de Investigaciones Científicas y Técnicas
repository.name.fl_str_mv CONICET Digital (CONICET) - Consejo Nacional de Investigaciones Científicas y Técnicas
repository.mail.fl_str_mv dasensio@conicet.gov.ar; lcarlino@conicet.gov.ar
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score 12.982451

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