A national quality improvement (QI) initiative resulted in increases in appropriate antibiotic prescribing for pediatric infections at 118 US hospitals, as published in Pediatrics. The QI program sought to encourage the use of appropriate antibiotic therapy for community-acquired pneumonia, skin and other soft-tissue infection, and urinary tract infection. Program actions included monthly feedback, education, coaching, order sets, and a mobile app with treatment recommendations. Overall, adherence to empirical antibiotic therapy was 72%; definitive antibiotic therapy was 79%; and duration of therapy was 71% during the intervention period—demonstrating improvements in each from baseline adherence. Sites included hospitals participating in the American Academy of Pediatrics Value in Inpatient Pediatrics Network.
Need for QI programs: Authors cite the literature showing 25% of antibiotics prescribed to children are either inappropriate or unnecessary and say even with guidelines, antibiotic prescription practices can vary widely.
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