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
- Institución
- Consejo Nacional de Investigaciones Científicas y Técnicas
- OAI Identificador
- oai:ri.conicet.gov.ar:11336/266153
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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 Técnicas2025-09-29T10:24:55Zoai: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:34982025-09-29 10:24:55.336CONICET 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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1844614246814449664 |
score |
13.070432 |