# Opportunities for collaboration: the synergy between antimicrobial and diagnostic stewardship in pediatrics

## TL;DR

This paper explores how antimicrobial and diagnostic stewardship can work together in pediatric care to improve patient outcomes and reduce waste.

## Contribution

The paper introduces five collaborative moments between antimicrobial and diagnostic stewardship in pediatrics to enhance care quality.

## Key findings

- Five key moments for collaboration between antimicrobial and diagnostic stewardship are identified.
- Examples from common pediatric diagnostic scenarios illustrate the impact of stewardship collaboration.
- Collaboration can reduce financial and environmental waste in healthcare.

## Abstract

Advancement of antimicrobial stewardship (AS) programs requires partnership with clinicians, quality assurance teams, and laboratorians. Inevitably, AS programs also practice diagnostic stewardship (DS), as stewards are aptly placed to connect key stakeholders and help steer processes toward higher value care for pediatric patients. In this review, we illustrate five moments of collaboration between stakeholders in the interplay between AS and DS in pediatrics. These moments include (1) Observation, (2) Reflection, (3) Exploration, (4) Enactment and (5) Evaluation. We offer a targeted narrative of examples in current literature using common relatable scenarios (ie, endotracheal aspirates, blood cultures, gastrointestinal samples, and urine testing) including impact on financial and environmental waste.