Antibiotic and Diagnostic Discordance Between ED Physicians and Hospitalists for Pediatric Respiratory Illness

Hospital Pediatrics
Eric R CoonMark W Shen

Abstract

Imperfect diagnostic tools make it difficult to know the extent to which a bacterial process is contributing to respiratory illness, complicating the decision to prescribe antibiotics. We sought to quantify diagnostic and antibiotic prescribing disagreements between emergency department (ED) and pediatric hospitalist physicians for children admitted with respiratory illness. Manual chart review was used to identify testing, diagnostic, and antibiotic prescribing decisions for consecutive children admitted for respiratory illness in a winter (starting February 20, 2012) and a summer (starting August 20, 2012) season to a tertiary, freestanding children's hospital. Respiratory illness diagnoses were grouped into 3 categories: bacterial, viral, and asthma. A total of 181 children admitted for respiratory illness were studied. Diagnostic discordance was significant for all 3 types of respiratory illness but greatest for bacterial (P<.001). Antibiotic prescribing discordance was significant (P<.001), with pediatric hospitalists changing therapy for 93% of patients prescribed antibiotics in the ED, including stopping antibiotics altogether for 62% of patients. Significant diagnostic and antibiotic discordance between ED and pediatric...Continue Reading

References

Jul 31, 1975·The New England Journal of Medicine·S G Pauker, J P Kassirer
Nov 1, 1984·Archives of Disease in Childhood·B FriisP Uldall
Dec 24, 1997·JAMA : the Journal of the American Medical Association·T P MeehanJ M Fine
Apr 27, 2000·The Pediatric Infectious Disease Journal·T JuvénO Ruuskanen
Aug 29, 2001·The American Journal of the Medical Sciences·C LawrenceJ Shuter
Nov 21, 2001·European Journal of Clinical Microbiology & Infectious Diseases : Official Publication of the European Society of Clinical Microbiology·S EspositoUNKNOWN Mowgli Study Group
Dec 6, 2001·The Pediatric Infectious Disease Journal·C OchoaUNKNOWN Spanish Study Group on Antibiotic Treatments
Apr 30, 2002·Thorax·R VirkkiO Ruuskanen
Nov 20, 2002·Clinical Infectious Diseases : an Official Publication of the Infectious Diseases Society of America·Susanna EspositoNicola Principi
Mar 11, 2004·JAMA : the Journal of the American Medical Association·Robert H PantellRichard C Wasserman
Sep 10, 2004·Clinical Infectious Diseases : an Official Publication of the Infectious Diseases Society of America·M N TsoliaN G Papadopoulos
Nov 7, 2007·The Pediatric Infectious Disease Journal·Daniel K L CheukSusan S Chiu
Feb 27, 2008·Archives of Internal Medicine·James A WelkerJack D McCue
Jul 17, 2008·Academic Emergency Medicine : Official Journal of the Society for Academic Emergency Medicine·Stefan G VanderweilCarlos A Camargo
Mar 13, 2009·European Journal of Clinical Microbiology & Infectious Diseases : Official Publication of the European Society of Clinical Microbiology·A H W BrunsA I M Hoepelman
Oct 31, 2009·The Journal of Pediatrics·Jennifer J WilkesTheoklis E Zaoutis
Dec 25, 2009·The Pediatric Infectious Disease Journal·Sonal ShahMark I Neuman
Oct 5, 2010·The American Journal of Emergency Medicine·Abhinav ChandraAlexander Limkakeng
May 25, 2011·Pediatrics·Kris De BoeckMarijke Proesmans
May 25, 2011·Pediatrics·Ian M PaulMichael D Cabana
Jun 30, 2011·Pediatric Emergency Care·Mark I NeumanRichard Bachur
Jul 13, 2011·Pediatrics·Mark I NeumanRichard G Bachur
Aug 23, 2011·The American Journal of Emergency Medicine·Rishi SikkaErik B Kulstad
Sep 2, 2011·Clinical Infectious Diseases : an Official Publication of the Infectious Diseases Society of America·John S BradleyUNKNOWN Pediatric Infectious Diseases Society and the Infectious Diseases Society of America
Apr 26, 2012·The Pediatric Infectious Disease Journal·María Luz García-GarcíaInmaculada Casas
Jun 2, 2012·The Pediatric Infectious Disease Journal·Thomas V BroganSamir S Shah
Aug 2, 2012·Academic Emergency Medicine : Official Journal of the Society for Academic Emergency Medicine·Jeffrey M Caterino, Kurt B Stevenson
Aug 21, 2012·Archives of Disease in Childhood·C Ronny L H Cheung, J A Muir Gray
Nov 30, 2012·The Pediatric Infectious Disease Journal·Débora Natalia MarconeMarcela Echavarría
Jan 24, 2013·JAMA : the Journal of the American Medical Association·Jay G BerryMark A Schuster
Mar 20, 2013·International Journal of Infectious Diseases : IJID : Official Publication of the International Society for Infectious Diseases·Jose BordonJulio Ramirez

❮ Previous
Next ❯

Citations

Mar 11, 2016·Current Infectious Disease Reports·Russell J McCulloh, Karisma Patel
Oct 14, 2021·European Journal of Clinical Microbiology & Infectious Diseases : Official Publication of the European Society of Clinical Microbiology·Pierre-Marie RogerOlivier Pantaloni
Feb 6, 2017·Pediatrics·Kavita ParikhUNKNOWN Value in Inpatient Pediatrics Network Quality Collaborative For Improving Care In Community Acquired Pneumonia
Aug 30, 2018·Pediatrics·Matthew D Garber, Ricardo A Quinonez

❮ Previous
Next ❯

Related Concepts

Related Feeds

Asthma

This feed focuses in Asthma in which your airways narrow and swell. This can make breathing difficult and trigger coughing, wheezing and shortness of breath.

Antifungals (ASM)

An antifungal, also known as an antimycotic medication, is a pharmaceutical fungicide or fungistatic used to treat and prevent mycosis such as athlete's foot, ringworm, candidiasis, cryptococcal meningitis, and others. Discover the latest research on antifungals here.

Antifungals

An antifungal, also known as an antimycotic medication, is a pharmaceutical fungicide or fungistatic used to treat and prevent mycosis such as athlete's foot, ringworm, candidiasis, cryptococcal meningitis, and others. Discover the latest research on antifungals here.

Allergy and Asthma

Allergy and asthma are inflammatory disorders that are triggered by the activation of an allergen-specific regulatory t cell. These t cells become activated when allergens are recognized by allergen-presenting cells. Here is the latest research on allergy and asthma.

© 2022 Meta ULC. All rights reserved