Evidence-based clinical practice guideline for hospital-based antimicrobial stewardship programs: A national guideline adaptation by saudi pediatric infectious diseases society

Antimicrobial resistance (AMR) remains a pressing global health threat, and in Saudi Arabia, national surveillance trends continue to demonstrate rising resistance among key pathogens. In response, a national evidence-based guideline for hospital-based antimicrobial stewardship programs (ASPs) was developed to guide the implementation of systematic interventions that promote optimal antimicrobial use. The Saudi Pediatric Infectious Diseases Society, in partnership with national and academic partners, led the adaptation of the 2018 Infectious Diseases Society of America/ Society for Healthcare Epidemiology of America ASP clinical practice guideline (CPG) using the king saud university (KSU)-Modified-ADAPTE methodology. Twenty-seven clinical questions were prioritized to formulate 31 recommendations categorized across six sections: antibiotic utilization, optimization strategies, microbiology and laboratory diagnostics, special populations, outcome measures, and organizational support. It included CPG implementation tools (i.e., proposed ASP committee structure, key performance indicators, audit templates, integration guidance aligned with Saudi Ministry of Health and Public Health Authority frameworks, patient health educational material, and patient experience stories). This CPG was registered in the PREPARE registry and reported using the RIGHT-Ad@pt reporting checklist for adapted CPGs. It represents a milestone in Saudi Arabia’s coordinated AMR containment strategy, providing a standardized and scalable model for ASP deployment across hospital settings.