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Improving antibiotic prescribing in the emergency department for uncomplicated community-acquired pneumonia

World Journal of Emergency Medicine 2020年第4期11卷 199-205页

作者： Rebekah Shaw Erica Popovsky alyssa abo Marni Jacobs Nicole Herrera James Chamberlain AndreaHahn Division of Pediatrics Children’s National Health SystemWashingtonDCUSA Division of Emergency Medicine Children’s National Health SystemWashingtonDCUSA Department of Pediatrics George Washington University School of Medicine and Health SciencesWashingtonDCUSA Division of Biostatistics and Epidemiology Children’s National Health SystemWashingtonDCUSA Division of Infectious Diseases Children’s National Health SystemWashingtonDCUSA

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 *** 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 *** aim of this study was to examine baseline knowledge and ED provider prescribing patterns pre-and post-CPG ***: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 ***:ED providers were aware of the PIDS/IDSA guideline recommendations,with 86.4%of survey responders selecting ampicillin as the initial antibiotic of ***,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 *** of a CPG in isolation did not significantly change prescribing patterns for uncomplicated CAP.

关键词： Antibiotics Community-acquired pneumonia Emergency department Pediatrics

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