Effects of clinical pathway implementation on antibiotic prescriptions for pediatric community-acquired pneumonia

PloS One
Daniele DonàCarlo Giaquinto

Abstract

Italian pediatric antimicrobial prescription rates are among the highest in Europe. As a first step in an Antimicrobial Stewardship Program, we implemented a Clinical Pathway (CP) for Community Acquired Pneumonia with the aim of decreasing overall prescription of antibiotics, especially broad-spectrum. The CP was implemented on 10/01/2015. We collected antibiotic prescribing and outcomes data from children aged 3 months-15 years diagnosed with CAP from 10/15/2014 to 04/15/2015 (pre-intervention period) and from 10/15/2015 to 04/15/2016 (post-intervention period). We assessed antibiotic prescription differences pre- and post-CP, including rates, breadth of spectrum, and duration of therapy. We also compared length of hospital stay for inpatients and treatment failure for inpatients and outpatients. Chi-square and Fisher's exact test were used to compare categorical variables and Wilcoxon rank sum test was used to compare quantitative outcomes. 120 pre- and 86 post-intervention clinic visits were identified with a diagnosis of CAP. In outpatients, we observed a decrease in broad-spectrum regimens (50% pre-CP vs. 26.8% post-CP, p = 0.02), in particular macrolides, and an increase in narrow-spectrum (amoxicillin) post-CP. Post-CP c...Continue Reading

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Citations

Sep 2, 2019·Current Infectious Disease Reports·Kelli A ColeLisa E Dumkow
Oct 31, 2019·Expert Review of Anti-infective Therapy·Chiara TersigniLuisa Galli
Jan 9, 2020·Antimicrobial Resistance and Infection Control·D DonàM Sharland
Oct 4, 2019·Pediatric Quality & Safety·Aimee Pugh-BernardLeigh Anne Bakel
Aug 20, 2019·Italian Journal of Pediatrics·E BarbieriC Giaquinto
May 10, 2020·Antimicrobial Resistance and Infection Control·D DonàM Sharland
Mar 21, 2021·NPJ Primary Care Respiratory Medicine·Elisa BarbieriDaniele Donà
Mar 25, 2021·PloS One·Alex AregbesolaTerry P Klassen
Oct 16, 2020·The Pediatric Infectious Disease Journal·Paola CostenaroDaniele Donà
Jul 31, 2021·Hospital Pediatrics·W Aaron Manning, Leigh Anne Bakel

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