Tribble AC, Lee BR, Flett KB, et al. - Researchers sought to characterize inappropriate prescribing practices for children so that pediatric antimicrobial stewardship could be guided. In this cross-sectional analysis, they assessed antibiotic prescribing among hospitalized children with ≥ 1 antibiotic order at 0800 on 1 day per calendar quarter, over six quarters (Quarter 3 2016 – Quarter 4 2017) at 32 US children’s hospitals. Hospitalization of 34,927 children was reported on survey days; of these, 12,213 (35.0%) had ≥ 1 active antibiotic order. They identified the reception of one or more antibiotics at any given time in nearly 1 in 3 hospitalized children. Receipt of suboptimal therapy was reported in one-quarter of these children, and current antimicrobial stewardship program practices do not capture nearly half of suboptimal use. Reasons for inappropriate use comprised bug-drug mismatch (27.7%), surgical prophylaxis > 24 hours (17.7%), overly broad empiric therapy (11.2%), and unnecessary treatment (11.0%).