BACKGROUND:The Pediatric Infectious Disease Society(PIDS)and Infectious Disease Society of America(IDSA)published an evidence-based guideline for the treatment of uncomplicated communityacquired pneumonia(CAP)in child...BACKGROUND:The Pediatric Infectious Disease Society(PIDS)and Infectious Disease Society of America(IDSA)published an evidence-based guideline for the treatment of uncomplicated communityacquired pneumonia(CAP)in children,recommending aminopenicillins as the first-line therapy.Poor guideline compliance with 10%–50%of patients admitted to the hospital receiving narrow-spectrum antibiotics has been reported.A new clinical practice guideline(CPG)was implemented in our emergency department(ED)for uncomplicated CAP.The aim of this study was to examine baseline knowledge and ED provider prescribing patterns pre-and post-CPG implementation.METHODS:Prior to CPG-implementation,an anonymous case-based survey was distributed to evaluate knowledge of the current PIDS/IDSA guideline.A retrospective chart review of patients treated in the ED for CAP from January 2015 to February 2017 was performed to assess prescribing patterns for intravenous(IV)antibiotics in the ED at Children’s National Health System pre-and post-CPG implementation.RESULTS:ED providers were aware of the PIDS/IDSA guideline recommendations,with 86.4%of survey responders selecting ampicillin as the initial antibiotic of choice.However,only 41.2%of patients admitted to the hospital with uncomplicated CAP pre-CPG received ampicillin(P<0.01).There was no statistically signifi cant increase in ampicillin prescribing post-CPG(P=0.40).CONCLUSIONS:Providers in the ED are aware of the PIDS/IDSA guideline regarding the first-line therapy for uncomplicated CAP;however,this knowledge does not translate into clinical practice.Implementation of a CPG in isolation did not significantly change prescribing patterns for uncomplicated CAP.展开更多
基金Drs.Rebekah Shaw and Erica Popovsky received protected time for research during their pediatric residency through the Research,Education,Advocacy,and Child Health Care(REACH)program at Children’s National Health System.During the study period,Dr.Andrea Hahn was also funded in part by the National Institute of Health(NIH)National Heart,Lung,and Blood Institute(K12 HL119994).Biostatical support was provided by the Clinical and Translational Science Institute at Children’s National Health System(UL1TR000075)through the NIH National Center for Advancing Translational Sciences.Its contents are solely the responsibility of the authors and do not necessarily represent the offi cial views of the National Center for Advancing Translational Sciences or the National Institutes of Health.
文摘BACKGROUND:The Pediatric Infectious Disease Society(PIDS)and Infectious Disease Society of America(IDSA)published an evidence-based guideline for the treatment of uncomplicated communityacquired pneumonia(CAP)in children,recommending aminopenicillins as the first-line therapy.Poor guideline compliance with 10%–50%of patients admitted to the hospital receiving narrow-spectrum antibiotics has been reported.A new clinical practice guideline(CPG)was implemented in our emergency department(ED)for uncomplicated CAP.The aim of this study was to examine baseline knowledge and ED provider prescribing patterns pre-and post-CPG implementation.METHODS:Prior to CPG-implementation,an anonymous case-based survey was distributed to evaluate knowledge of the current PIDS/IDSA guideline.A retrospective chart review of patients treated in the ED for CAP from January 2015 to February 2017 was performed to assess prescribing patterns for intravenous(IV)antibiotics in the ED at Children’s National Health System pre-and post-CPG implementation.RESULTS:ED providers were aware of the PIDS/IDSA guideline recommendations,with 86.4%of survey responders selecting ampicillin as the initial antibiotic of choice.However,only 41.2%of patients admitted to the hospital with uncomplicated CAP pre-CPG received ampicillin(P<0.01).There was no statistically signifi cant increase in ampicillin prescribing post-CPG(P=0.40).CONCLUSIONS:Providers in the ED are aware of the PIDS/IDSA guideline regarding the first-line therapy for uncomplicated CAP;however,this knowledge does not translate into clinical practice.Implementation of a CPG in isolation did not significantly change prescribing patterns for uncomplicated CAP.
