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Life sciences · Journal article
Journal of the Pediatric Infectious Diseases Society · September 1, 2026
Early or partial results. Treat as a signal, not a conclusion.
This is a descriptive point prevalence survey of pediatric antimicrobial prescribing at a single tertiary hospital in Guatemala, identifying high rates of overall antimicrobial use (72% of 82 patients) and inappropriate prescriptions (57.4% of 101 prescriptions). The findings map local prescribing patterns and barriers to stewardship but do not test an intervention or establish outcomes beyond prevalence estimates.
Single-center, cross-sectional point prevalence survey. Pediatric patients admitted to the National Hospital of Escuintla, Guatemala, a tertiary care facility. No age range, admission criteria, exclusion criteria, or baseline clinical characteristics are specified.. n = 82. National Hospital of Escuintla, Guatemala.
72% of 82 pediatric patients received at least one antimicrobial 101 total antimicrobial prescriptions evaluated, with 57.4% found to be inappropriate 57.4% of prescriptions inappropriate due to incorrect dose (38.2%), too broad empirically (17.7%), too broad based on culture (13.2%), or unnecessary duplicate therapy (10.3%)
Safety was not reported in the material analysed. Check the source before drawing any conclusion about harm.
These findings identify substantial gaps in antimicrobial stewardship at a Central American tertiary hospital, particularly dosing errors and overly broad empirical coverage. Clinicians and stewardship teams in Guatemala and resource-limited settings may use these data to prioritize targeted interventions such as dosing protocols and disease-specific guidelines, though effectiveness of such interventions is not demonstrated here.
Single-center point prevalence survey of antimicrobial prescribing patterns over a 3-day period; descriptive findings identify local stewardship gaps but lack a comparator, control group, or intervention outcome to establish causality or effectiveness.
As stated by the source record.
Quoted from the source exactly as published.
These findings identify substantial gaps in antimicrobial stewardship at a Central American tertiary hospital, particularly dosing errors and overly broad empirical coverage. Clinicians and stewardship teams in Guatemala and resource-limited settings may use these data to prioritize targeted interventions such as dosing protocols and disease-specific guidelines, though effectiveness of such interventions is not demonstrated here.
Graded across the dimensions that decide whether you should act, each from what the source actually supports. There is no single score, and where a dimension was not assessed it says so.
Abstract Corresponding Author Lee Morris, MD MSPH DTM&H, Department of Pediatrics, Division of Pediatric Infectious Diseases and Immunology, Wake Forest University School of Medicine and Atrium Health Levine Children’s Hospital, 1000 Blythe Blvd, Charlotte, NC, 28232, USA, (919)260-8623, Lee.morris@advocatehealth.org Funding This work was supported by the Heineman-Robicsek Foundation Conflicts of Interest Keerti Dantuluri, no conflict; Sofia Posadas, no conflict; Jeanne B Forrester, no conflict; Lee Morris, no conflict. Background Antimicrobial misuse is a major contributor to antimicrobial resistance (AMR), a top global health threat. Latin America has high baseline rates of AMR among hospitalized children. Understanding local patterns of antimicrobial utilization and identifying barriers to antimicrobial stewardship implementation are essential components of stewardship efforts. However, data on antimicrobial prescribing patterns in Central America, particularly in Guatemala, are limited. We conducted an evaluation of pediatric antimicrobial utilization at a tertiary hospital in Guatemala to guide the development of local antimicrobial stewardship interventions. Methods We evaluated antimicrobial utilization in pediatric patients admitted to the National Hospital of Escuintla, Guatemala between 7/14/25 – 7/16/25 by conducting a single-center point prevalence study. In addition to demographic, microbiologic, and antimicrobial use data, we assessed the overall prevalence of antimicrobial use, indications and appropriateness of antimicrobials prescribed, and attainment of appropriate cultures. Results A total of 82 pediatric patients and 101 antimicrobial prescriptions were evaluated. Seventy-two percent of pediatric patients received at least one antimicrobial. The most common antimicrobials were piperacillin-tazobactam (14.9%), ceftriaxone (13.9%), meropenem (12.9%), vancomycin (11.9%) and amikacin (10.9%) (Figure 1). The top antimicrobial indications were sepsis (41.7%), pulmonary infection (24.4%) and prophylaxis (9.6%). High rates of inappropriate antimicrobial use were observed in the PICU (46.9%), NICU (64.7%), medical wards (53.8%), surgery ward (83.3%) and nursery (40%). The majority (57.4%) of prescriptions were found to be inappropriate due to incorrect dose (38.2%), too broad empirically (17.7%), too broad based on culture (13.2%), and unnecessary duplicate therapy (10.3%) (Table 1). Finally, 85.7% of patients had cultures obtained when indicated (75% of which were obtained prior to antimicrobials). Conclusion Through our study, we found high rates of antimicrobial prescribing and inappropriate use amongst hospitalized pediatric patients at a tertiary hospital in Guatemala. Based upon our findings, strategies for antimicrobial stewardship implementation can include providing dosing charts and disease-specific treatment guidelines for providers.
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