Journal article
Discharge antibiotic prescribing at children’s hospitals with established antimicrobial stewardship programs
Infection control and hospital epidemiology, v 46(6), pp 623-628
01 Jun 2025
PMID: 40196890
Featured in Collection : UN Sustainable Development Goals @ Drexel
Abstract
Objective:
Antibiotic stewardship programs (ASPs) target hospitalized children, but most do not routinely review antibiotic prescriptions at discharge, despite 30% of discharged children receiving additional antibiotics. Our objective is to describe discharge antibiotic prescribing in children hospitalized for uncomplicated community-acquired pneumonia (CAP), skin/soft tissue infection (SSTI), and urinary tract infection (UTI).
Design:
Retrospective cohort study.
Setting:
Four academic children’s hospitals with established ASPs.
Patients:
ICD-10 codes identified 3,847 encounters for children <18 years admitted from January 1, 2021 to December 31, 2021 and prescribed antibiotics at discharge for uncomplicated CAP, SSTI, or UTI. After excluding children with medical complexity and encounters with concomitant infections, >7 days hospital stay, or intensive care unit stay, 1,206 encounters were included.
Methods:
Primary outcomes were the percentage of subjects prescribed optimal (1) total (inpatient plus outpatient) duration of therapy (DOT) and (2) antibiotic choice based on current national guidelines and available evidence.
Results:
Of 226 encounters for CAP, 417 for UTI, and 563 for SSTI, the median age was 4 years, 52% were female, and the median DOT was 9 days (8 for CAP, 10 for UTI, and 9 for SSTI). Antibiotic choice was optimal for 77%, and DOT was optimal for 26%. Only 20% of antibiotic courses included both optimal DOT and antibiotic choice.
Conclusions:
At 4 children’s hospitals with established ASPs, 80% of discharge antibiotic courses for CAP, UTI, and SSTI were suboptimal either by choice of antibiotic or DOT. Discharge antibiotic prescribing represents an opportunity to improve antibiotic use in children.
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Details
- Title
- Discharge antibiotic prescribing at children’s hospitals with established antimicrobial stewardship programs
- Creators
- Rebecca G. Same - Children's Hospital of PhiladelphiaGiyoung Lee - Drexel University, Community Health and PreventionJared Olson - Primary Children's HospitalBrendan Bettinger - Seattle Children's HospitalAdam L. Hersh - University of UtahMatthew P. Kronman - Seattle Children's HospitalJason G. Newland - Pediatric Infectious Diseases, Nationwide Children’s Hospital, Columbus, OH, United StatesMeg Grimshaw - Spencer FoundationJeffrey S. Gerber - Children's Hospital of Philadelphia
- Publication Details
- Infection control and hospital epidemiology, v 46(6), pp 623-628
- Number of pages
- 6
- Grant note
- Agency for Healthcare Research and Quality (http://data.elsevier.com/vocabulary/SciValFunders/100000133) R01HS027428-01 / Agency for Healthcare Research and Quality (http://data.elsevier.com/vocabulary/SciValFunders/100000133)
- Resource Type
- Journal article
- Language
- English
- Academic Unit
- Community Health and Prevention
- Web of Science ID
- WOS:001462778200001
- Scopus ID
- 2-s2.0-105002389733
- Other Identifier
- 991022176174504721
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- Collaboration types
- Domestic collaboration
- Web of Science research areas
- Infectious Diseases
- Public, Environmental & Occupational Health