{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,29]],"date-time":"2026-10-29T00:58:58Z","timestamp":1793235538204,"version":"4.5.0"},"reference-count":144,"publisher":"MDPI AG","issue":"2","license":[{"start":{"date-parts":[[2025,1,27]],"date-time":"2025-01-27T00:00:00Z","timestamp":1737936000000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"name":"EU funding within the NextGenerationEU-MUR M4C2.I.1.3 PNRR Extended Partnership initiative on Emerging Infectious Diseases","award":["PE00000007"],"award-info":[{"award-number":["PE00000007"]}]},{"name":"EU funding within the NextGenerationEU-MUR M4C2.I.1.3 PNRR Extended Partnership initiative on Emerging Infectious Diseases","award":["COC-1- 2023-ISS-01"],"award-info":[{"award-number":["COC-1- 2023-ISS-01"]}]},{"name":"EU funding within the NextGenerationEU-MUR M4C2.I.1.3 PNRR Extended Partnership initiative on Emerging Infectious Diseases","award":["CUP I83C22001810007"],"award-info":[{"award-number":["CUP I83C22001810007"]}]},{"name":"One Health Basic and Translational Research Actions addressing Unmet Needs on Emerging Infectious Diseases","award":["PE00000007"],"award-info":[{"award-number":["PE00000007"]}]},{"name":"One Health Basic and Translational Research Actions addressing Unmet Needs on Emerging Infectious Diseases","award":["COC-1- 2023-ISS-01"],"award-info":[{"award-number":["COC-1- 2023-ISS-01"]}]},{"name":"One Health Basic and Translational Research Actions addressing Unmet Needs on Emerging Infectious Diseases","award":["CUP I83C22001810007"],"award-info":[{"award-number":["CUP I83C22001810007"]}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Antibiotics"],"abstract":"<jats:p>Antimicrobial stewardship programs (ASPs) and diagnostic stewardship programs (DSPs) are essential strategies for effectively managing infectious diseases and tackling antimicrobial resistance (AMR). These programs can have a complementary impact, i.e., ASPs optimize antimicrobial use to prevent resistance, while DSPs enhance diagnostic accuracy to guide appropriate treatments. This review explores the current landscape of ASPs and DSPs in pediatric care, focusing on key factors, influencing their development, implementation, and evaluation across various settings. A multidisciplinary approach is necessary, involving multiple healthcare professionals to support comprehensive stewardship practices in pediatric care. No single intervention suits all settings, or even the same setting, in different countries; interventions must be tailored to each specific context, considering factors such as hospital capacity, patient complexity, and the parent\u2013child dynamic. It is essential to educate caregivers on optimal antibiotic use through clear, concise messages adapted to their socioeconomic status and level of understanding. The cost-effectiveness of ASPs and DSPs should also be assessed, and standardized metrics should be employed to evaluate success in pediatric settings, focusing on outcomes beyond just antibiotic consumption, such as AMR rates. This manuscript further discusses emerging opportunities and challenges in ASP implementation, offering insights into future research priorities. These include large-scale studies to evaluate the long-term impact of ASPs, cost-effectiveness assessments of pediatric-specific diagnostic tools, and the integration of artificial intelligence to support clinical decision making. Addressing these areas will enhance the effectiveness and sustainability of ASPs, contributing to global efforts to combat AMR and improve pediatric health outcomes.<\/jats:p>","DOI":"10.3390\/antibiotics14020132","type":"journal-article","created":{"date-parts":[[2025,1,27]],"date-time":"2025-01-27T04:59:10Z","timestamp":1737953950000},"page":"132","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":29,"title":["State of the Art of Antimicrobial and Diagnostic Stewardship in Pediatric Setting"],"prefix":"10.3390","volume":"14","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-7105-2105","authenticated-orcid":false,"given":"Daniele","family":"Don\u00e0","sequence":"first","affiliation":[{"name":"Division of Pediatric Infectious Diseases, Department for Woman and Child Health, University of Padua, 35128 Padua, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-0850-8784","authenticated-orcid":false,"given":"Elisa","family":"Barbieri","sequence":"additional","affiliation":[{"name":"Division of Pediatric Infectious Diseases, Department for Woman and Child Health, University of Padua, 35128 Padua, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Giulia","family":"Brigadoi","sequence":"additional","affiliation":[{"name":"Division of Pediatric Infectious Diseases, Department for Woman and Child Health, University of Padua, 35128 Padua, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-0821-5757","authenticated-orcid":false,"given":"Cecilia","family":"Liberati","sequence":"additional","affiliation":[{"name":"Division of Pediatric Infectious Diseases, Department for Woman and Child Health, University of Padua, 35128 Padua, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Samantha","family":"Bosis","sequence":"additional","affiliation":[{"name":"Pneumology and Infectious Diseases Unit, Fondazione IRCCS Ca\u2019 Granda Ospedale Maggiore Policlinico, 20122 Milano, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-5336-8429","authenticated-orcid":false,"given":"Elio","family":"Castagnola","sequence":"additional","affiliation":[{"name":"Infectious Diseases Unit, Department of Pediatrics, IRCCS Istituto Giannina Gaslini, 16147 Genoa, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-3245-9396","authenticated-orcid":false,"given":"Claudia","family":"Colomba","sequence":"additional","affiliation":[{"name":"Division of Pediatric Infectious Diseases, \u201cG. Di Cristina\u201d Hospital, ARNAS Civico Di Cristina Benfratelli, University of Palermo, 90134 Palermo, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-7912-3366","authenticated-orcid":false,"given":"Luisa","family":"Galli","sequence":"additional","affiliation":[{"name":"Department of Health Sciences, University of Florence, 50139 Florence, Italy"},{"name":"Infectious Diseases Unit, Meyer Children\u2019s University Hospital, IRCCS, 50139 Florence, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Laura","family":"Lancella","sequence":"additional","affiliation":[{"name":"Infectious Diseases Unit, Bambino Ges\u00f9 Children\u2019s Hospital, IRCCS, 00165 Rome, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-4181-6842","authenticated-orcid":false,"given":"Andrea","family":"Lo Vecchio","sequence":"additional","affiliation":[{"name":"Department of Translational Medical Sciences, Federico II University, 80138 Naples, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-1254-9995","authenticated-orcid":false,"given":"Marianna","family":"Meschiari","sequence":"additional","affiliation":[{"name":"Department of Infectious Diseases, Azienda Ospedaliero-Universitaria di Modena, University of Modena and Reggio Emilia, 41125 Modena, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-5950-4965","authenticated-orcid":false,"given":"Carlotta","family":"Montagnani","sequence":"additional","affiliation":[{"name":"Infectious Diseases Unit, Meyer Children\u2019s University Hospital, IRCCS, 50139 Florence, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-7549-3514","authenticated-orcid":false,"given":"Maia","family":"De Luca","sequence":"additional","affiliation":[{"name":"Infectious Diseases Unit, Bambino Ges\u00f9 Children\u2019s Hospital, IRCCS, 00165 Rome, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Stefania","family":"Mercadante","sequence":"additional","affiliation":[{"name":"Infectious Diseases Unit, Bambino Ges\u00f9 Children\u2019s Hospital, IRCCS, 00165 Rome, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-4103-2837","authenticated-orcid":false,"given":"Susanna","family":"Esposito","sequence":"additional","affiliation":[{"name":"Pediatric Clinic, Parma University Hospital, Department of Medicine and Surgery, University of Parma, 43126 Parma, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1968","published-online":{"date-parts":[[2025,1,27]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","unstructured":"Principi, N., and Esposito, S. 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