P-1682. Evaluation of Antibiotic Prescribing Practices for Pediatric Acute Otitis Media and Community-Acquired Pneumonia in an Emergency Department
Notice bibliographique
Résumé
Abstract Background Acute otitis media (AOM) and community-acquired pneumonia (CAP) are common reasons for antibiotic prescriptions in children. As a result, antimicrobial stewardship efforts ensuring evidence-informed antibiotic prescriptions may be impactful. The objective of this study was to assess whether antibiotic prescriptions for AOM and CAP in a pediatric emergency department (ED) are consistent with current guidelines, and to identify opportunities for improvement. Duration of antibiotics prescribed for acute otitis media Bar graph depicting prescribed durations of therapy for acute otitis media, Prescriptions consistent with current guideline recommendations are in blue, while those that aren’t are in orange. Guidelines advise 10 days, rather than 5 days, of antibiotic therapy for children <2, perforated otitis media, treatment failure and recurrent otitis media. Methods We conducted a retrospective review of outpatient antibiotic prescriptions for AOM and CAP in the ED of a pediatric hospital from September 2022 to September 2023. Patients ages 0 – 18 years discharged from the ED with a diagnosis of AOM or CAP were identified using the electronic medical record system. Exclusion criteria included absence of a new antibiotic prescription, concomitant infections requiring antibiotic treatment, hospital admission, and patients with immunocompromising conditions or medications. Prescriptions were considered consistent with guidelines if they followed the Canadian Paediatric Society recommendations. Descriptive statistics were used for analysis. Duration of antibiotics prescribed for community-acquired pneumonia Bar graph depicting prescribed durations of therapy for community-acquired pneumonia. Prescriptions consistent with current guideline recommendations are in blue, while those that aren’t are in orange. Results A total of 1143 and 765 cases of AOM and CAP were included, respectively. Of the prescriptions for AOM, 688 (60%) were consistent with current guidelines. The 454 prescriptions that were not guideline-consistent were due to duration (n=281, 62%, Figure 1), dosing interval (n=142, 31%), antibiotic selection (n=74, 16%), and dose (n=38, 8.4%). Deferred prescriptions were provided to 177 (16%) patients; an additional 139 (12%) were eligible, but prescribed treatment. For CAP, 146 (19%) prescriptions were consistent with current guidelines. Of the 618 prescriptions that were not consistent, the majority were due to duration (n=576, 92%, Figure 2), dosing interval (n=134, 22%), antibiotic selection (n=38, 6%) and dose (n=14, 2%). Conclusion A significant number of patients with AOM (40%) and CAP (79%) were given antibiotic prescriptions that were not consistent with current guideline recommendations, with the most common reason being prolonged duration. This identifies an important antimicrobial stewardship opportunity in the ED and likely other outpatient settings. Disclosures Kathryn E. Timberlake, PharmD, Avir Pharma: Advisor/Consultant|Sanofi: Honoraria|Wolters Kluwer: Advisor/Consultant
Récupéré en direct depuis OpenAlex et désinversé. Les résumés ne sont pas conservés dans cette base de données : les index inversés représentent 8,6 Go des 9,3 Go de texte de la base, et le serveur dispose de 13 Go libres.
Comment cette classification a été obtenuedéplier
Prédiction machine sur la base complète
Imitation des enseignantsNi prévalence calibrée, ni vérité terrain. Validation humaine à venir. Le volet Gemma est une étiquette directe du modèle pour chaque travail de la base, lue sur la notice réduite au titre. Le volet Codex est un classifieur appris des 10 348 étiquettes directes de Codex et calibré sur les taux pondérés de l'échantillon; les champs sans appui suffisant ne portent aucun appel Codex. Le mode candidate est l'union des deux volets; le consensus est leur intersection. Ces sorties portent le statut machine_predicted_unvalidated et ne sont pas des étiquettes humaines.
Scores du classifieur distillé par catégorie (deux têtes)
| Catégorie | Codex | Gemma |
|---|---|---|
| Métarecherche | 0,001 | 0,008 |
| Méta-épidémiologie (sens strict) | 0,000 | 0,000 |
| Méta-épidémiologie (sens large) | 0,000 | 0,001 |
| Bibliométrie | 0,002 | 0,002 |
| Études des sciences et des technologies | 0,000 | 0,000 |
| Communication savante | 0,001 | 0,001 |
| Science ouverte | 0,000 | 0,000 |
| Intégrité de la recherche | 0,000 | 0,000 |
| Charge utile insuffisante (le modèle a refusé de juger) | 0,005 | 0,001 |
Scores machine (provisoires)
Les deux têtes enseignantes du modèle étudiant, lues sur ce travail. Un score ordonne la base pour la relecture; il n'affirme jamais une catégorie, et le statut de validation accompagne chaque rangée tel quel.
Scores de référence d'un modèle non mature (critères de maturité non atteints, 7 itérations). Un score ordonne; il n'affirme jamais une catégorie.
score_only:v0-immature-baseline · tel quel depuis la passe de notation : score_only signifie que le nombre peut ordonner les travaux, et qu'aucune étiquette de catégorie n'en découleClassification
machine, non validéePrédiction automatique; un appel candidat d’une seule source (Gemma direct ou Codex distillé), pas un consensus.
Le détail, modèle par modèle et score par score, se trouve en fin de page sous « Comment cette classification a été obtenue ».