Experience with developing antibiotic stewardship programmes in Serbia: potential model for other Balkan countries?

Introduction: Antimicrobial resistance (AMR) and inappropriate use of antibiotics in children are important issues. Consequently, there is a need to develop comprehensive stewardship programmes even in hospitals with limited resources starting with children’s hospitals. Method: Retrospective observational analysis of antimicrobial utilization and resistance patterns over five years in a tertiary care children’s hospital in Serbia. Results: Cumulative AMR decreased but were still high, with high cumulative resistance rates among the most widely used antibiotics in the hospital. Total antibiotic use decreased from 2010 to 2014 although there was still high prescribing of reserved antibiotics. Conclusion: Concerns with inappropriate use, and high resistance rates, among some antibiotics used in the hospital are being used to develop guidance on future antibiotic use in this hospital, building on the recently introduced antibiotic stewardship programme, as well as encourage other hospitals in Serbia to review their policies.