Antibiotic Stewardship

This project is being led by Dr. Shawn Rangel of Boston Children’s. It is scheduled to launch Fall 2023.3

Overuse of SAP has been associated with antimicrobial resistance and preventable patient harm. Preliminary analysis of ACS NSQIP Pediatric Antibiotic Stewardship Pilot data has demonstrated overuse to be both variable and common, and that more intensive use of unindicated postoperative prophylaxis was not correlated with lower SSI rates among its 96 pilot hospitals (figure). Great opportunity therefore exist within ACS NSQIP Pediatric for improving stewardship through sharing of best practices to reduce postoperative prophylaxis use. With these considerations, the primary goal of the PSQC Antibiotic Stewardship Collaborative will be to reduce postoperative utilization at participating sites through the following avenues (among others):

  1. Identification of high performing hospitals for dissemination of best practices for improved antimicrobial stewardship (low O/E’s for procedure-adjusted postoperative prophylaxis use with as expected or lower than expected O/E’s for SSI)
  2. Establishment of prophylaxis stewardship implementation/change teams at participating hospitals (surgeon/anesthesiologist/ASP personnel)
  3. Development and dissemination of procedure-level comparative effectiveness data for postoperative prophylaxis use commonly performed elective procedures (analysis currently in progress at the ACS)
  4. Identification of procedure-level low hanging fruit at each participating hospitals based on procedure-level comparative effectiveness data and existing site-specific SAP reports
  5. Development of site-level data dissemination and implementation/change plans for targeting “low hanging fruit”

For additional information, please contact the PSQC Program Manager, Terry Fisher, at




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