State of the Art of Antimicrobial and Diagnostic Stewardship in Pediatric Setting

Antimicrobial stewardship programs (ASPs) and diagnostic stewardship programs (DSPs) are es-sential strategies for effectively managing infectious diseases and tackling antimicrobial resistance (AMR). This narrative review highlights the necessity of a multidisciplinary approach, advocating for the involvement of diverse healthcare professionals to support comprehensive stewardship practices in pediatric care. Emphasizing the importance of setting-specific interventions across inpatient, outpatient, and emergency contexts, the review calls for enhanced education and col-laboration among healthcare providers and families. This analysis also underscores the cost-effectiveness of ASPs and explores metrics critical to evaluating their success in pediatrics, focusing on outcomes that go beyond antibiotic consumption to include metrics such as AMR rates. The manuscript further examines emerging opportunities and ongoing challenges in ASP implementation, outlining future research directions. Key priorities include large-scale studies to assess the long-term impacts of ASPs, cost-effectiveness evaluations of pediatric-specific diagnostic tools, and the potential for integrating artificial intelligence to support clinical decisions. Ad-dressing these areas will strengthen the effectiveness and sustainability of ASPs, ultimately con-tributing to global efforts against AMR and improving pediatric health outcomes.