Benchmarking of Outpatient Pediatric Antibiotic Prescribing: Results of a Multicenter Collaborative.

Autor: El Feghaly RE; Department of Pediatrics, Children's Mercy Kansas City, Kansas, Missouri, USA.; University of Missouri Kansas City School of Medicine, Kansas, Missouri, USA., Herigon JC; Department of Pediatrics, Children's Mercy Kansas City, Kansas, Missouri, USA.; University of Missouri Kansas City School of Medicine, Kansas, Missouri, USA., Kronman MP; Department of Pediatrics, University of Washington School of Medicine, Seattle, Washington, USA.; Seattle Children's Research institute, Seattle, Washington, USA., Wattles BA; School of Medicine, University of Louisville, Louisville, Kentucky, USA., Poole NM; Department of Pediatrics, Children's Hospital Colorado, University of Colorado, Aurora, Colorado, USA., Smith MJ; Department of Pediatrics, Duke University School of Medicine, Durham, North Carolina, USA., Vaughan AM; Department of Pediatrics, Division of Infectious Diseases, Boston Children's Hospital, Boston, Massachusetts, USA., Olivero R; Department of Pediatric and Human Development, Michigan State College of Human Medicine, Grand Rapids, Michigan, USA.; Department of Pediatrics, Helen DeVos Children's Hospital, Grand Rapids, Michigan, USA., Patel SJ; Department of Pediatrics, Ann and Robert H. Lurie Children's Hospital, Chicago, Illinois, USA.; Department of Pediatrics, Northwestern University Feinberg School of Medicine Chicago, Illinois, USA., Wirtz A; University of Missouri Kansas City School of Medicine, Kansas, Missouri, USA.; Department of Pharmacy, Children's Mercy Kansas City, Kansas, Missouri, USA., Willis Z; School of Medicine, University of North Carolina, Chapel Hill, North Carolina, USA., Lee BR; Department of Pediatrics, Children's Mercy Kansas City, Kansas, Missouri, USA.; University of Missouri Kansas City School of Medicine, Kansas, Missouri, USA.
Jazyk: angličtina
Zdroj: Journal of the Pediatric Infectious Diseases Society [J Pediatric Infect Dis Soc] 2023 Jun 30; Vol. 12 (6), pp. 364-371.
DOI: 10.1093/jpids/piad039
Abstrakt: Background: Most antibiotic use occurs in ambulatory settings. No benchmarks exist for pediatric institutions to assess their outpatient antibiotic use and compare prescribing rates to peers. We aimed to share pediatric outpatient antibiotic use reports and benchmarking metrics nationally.
Methods: We invited institutions from the Sharing Antimicrobial Reports for Pediatric Stewardship OutPatient (SHARPS-OP) Collaborative to contribute quarterly aggregate reports on antibiotic use from January 2019 to June 2022. Outpatient settings included emergency departments (ED), urgent care centers (UCC), primary care clinics (PCC) and telehealth encounters. Benchmarking metrics included the percentage of: (1) all acute encounters resulting in antibiotic prescriptions; (2) acute respiratory infection (ARI) encounters resulting in antibiotic prescriptions; and among ARI encounters receiving antibiotics, (3) the percentage receiving amoxicillin ("Amoxicillin index"); and (4) the percentage receiving azithromycin ("Azithromycin index"). We collected rates of antibiotic prescriptions with durations ≤7 days and >10 days from institutions able to provide validated duration data.
Results: Twenty-one institutions submitted aggregate reports. Percent ARI encounters receiving antibiotics were highest in the UCC (40.2%), and lowest in telehealth (19.1%). Amoxicillin index was highest for the ED (76.2%), and lowest for telehealth (55.8%), while the azithromycin index was similar for ED, UCC, and PCC (3.8%, 3.7%, and 5.0% respectively). Antibiotic duration of ≤7 days varied substantially (46.4% for ED, 27.8% UCC, 23.7% telehealth, and 16.4% PCC).
Conclusions: We developed a benchmarking platform for key pediatric outpatient antibiotic use metrics drawing data from multiple pediatric institutions nationally. These data may serve as a baseline measurement for future improvement work.
(© The Author(s) 2023. Published by Oxford University Press on behalf of The Journal of the Pediatric Infectious Diseases Society. All rights reserved. For permissions, please e-mail: journals.permissions@oup.com.)
Databáze: MEDLINE
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