Impact of a Personalized Audit and Feedback Intervention on Antibiotic Prescribing Practices for Outpatient Pediatric Community-Acquired Pneumonia.

Abstract:

:Antibiotic choice for pediatric community-acquired pneumonia (CAP) varies widely. We aimed to determine the impact of a 6-month personalized audit and feedback program on primary care providers' antibiotic prescribing practices for CAP. Participants in the intervention group received monthly personalized feedback. We then analyzed enrolled providers' CAP antibiotic prescribing practices. Participants diagnosed 316 distinct cases of CAP (214 control, 102 intervention); among these 316 participants, 301 received antibiotics (207 control, 94 intervention). In patients ≥5 years, the intervention group had fewer non-guideline-concordant antibiotics prescribed (22/103 [21.4%] control; 3/51 [5.9%] intervention, P < .05) and received more of the guideline-concordant antibiotics (amoxicillin and azithromycin). Personalized, scheduled audit and feedback in the outpatient setting was feasible and had a positive impact on clinician's selection of guideline-recommended antibiotics. Audit and feedback should be combined with other antimicrobial stewardship interventions to improve guideline adherence in the management of outpatient CAP.

journal_name

Clin Pediatr (Phila)

journal_title

Clinical pediatrics

authors

Diaz MCG,Handy LK,Crutchfield JH Jr,Cadilla A,Hossain J,Werk LN

doi

10.1177/0009922820928054

subject

Has Abstract

pub_date

2020-10-01 00:00:00

pages

988-994

issue

11

eissn

0009-9228

issn

1938-2707

journal_volume

59

pub_type

杂志文章
  • Differential response profiles in children and adolescents with attention-deficit/hyperactivity disorder: treatment with atomoxetine.

    abstract::Atomoxetine has been shown to be safe and effective in the treatment of attention-deficit/hyperactivity disorder (ADHD). The purpose of this post hoc analysis was to examine response trajectories of pediatric patients treated with atomoxetine. Data were pooled from 7 atomoxetine double-blind, placebo-controlled clinic...

    journal_title:Clinical pediatrics

    pub_type: 杂志文章,随机对照试验

    doi:10.1177/0009922814555973

    authors: Wietecha LA,Wang S,Saylor KE,Day KA,Wu SH,Kelsey D

    更新日期:2015-02-01 00:00:00

  • Severe hypernatremic dehydration secondary to undetected lactation failure: usefulness of sodium levels in breast milk.

    abstract::There is a concern that lactation failure and neonatal morbidity might be more common than previously thought. Maybe the early discharge, the lack of timely follow-up, or poor information during pregnancy or after delivery play important roles. A case of severe hypernatremic dehydration secondary to lactation failure ...

    journal_title:Clinical pediatrics

    pub_type: 杂志文章

    doi:10.1177/000992280604500211

    authors: Alsina-Manrique L,Esteban M,Salvià D,Miracle X,Rodríguez-Miguélez J,Figueras J,Carbonell X

    更新日期:2006-03-01 00:00:00

  • Undertriage of Pediatric Major Trauma Patients in the United States.

    abstract::Although trauma undertriage has been widely discussed in the literature, undertriage in the pediatric trauma population remains understudied. Using the 2009-2013 Nationwide Emergency Department Sample, we assessed the national undertriage rate in pediatric major trauma patients (age ≤16 years and injury severity score...

    journal_title:Clinical pediatrics

    pub_type: 杂志文章

    doi:10.1177/0009922817709553

    authors: Peng J,Wheeler K,Groner JI,Haley KJ,Xiang H

    更新日期:2017-08-01 00:00:00

  • A Tale of Smoking Cessation Promotion: The Utilization of a Children's Book to Increase Screening and Counseling in the Pediatric Clinic.

    abstract:OBJECTIVES:The rate at which pediatricians promote smoking cessation in clinical settings is low. The literature demonstrates that interventions paired with tangible health promotion materials may significantly increase screening rates to the pediatric office. The aim of this study was to investigate whether the additi...

    journal_title:Clinical pediatrics

    pub_type: 杂志文章,随机对照试验

    doi:10.1177/0009922816684607

    authors: Thomas KEH,Kisely S,Urrego F

    更新日期:2017-10-01 00:00:00

  • Does an Eczema Action Plan Improve Atopic Dermatitis? A Single-Site Randomized Controlled Trial.

    abstract::The multitude of treatment options for atopic dermatitis (AD) makes management frustrating for providers and patients. Eczema action plans (EAPs) have been proposed to improve parental and provider management. We developed a single-site randomized controlled trial to evaluate the impact of an EAP on quality of life (Q...

    journal_title:Clinical pediatrics

    pub_type: 杂志文章,随机对照试验

    doi:10.1177/0009922818795906

    authors: Brown J,Weitz NW,Liang A,Stockwell MS,Friedman S

    更新日期:2018-12-01 00:00:00

  • Fever of unknown origin: a diagnostic approach to this vexing problem.

    abstract::Fever is a common complaint leading families to seek medical attention. Its routine management is the bread and butter of pediatric practice. When fever is seen as prolonged beyond the expected time course (eg, 10 days for a presumed viral respiratory tract infection or 3 weeks for mononucleosis), concern for fever of...

    journal_title:Clinical pediatrics

    pub_type: 杂志文章,评审

    doi:10.1177/0009922809347799

    authors: Tolan RW Jr

    更新日期:2010-03-01 00:00:00

  • Potential substance abuse. Detection among adolescent patients. Using the Drug and Alcohol Problem (DAP) Quick Screen, a 30-item questionnaire.

    abstract::The authors administered an abbreviated revision of a previously field-tested, self-administered, brief screening test (the 30-item Drug and Alcohol Problem Quick Screen) to 355 consecutive middle-class adolescent patients seen at a five-pediatrician group practice setting. Ninety-six percent (341) of the subjects com...

    journal_title:Clinical pediatrics

    pub_type: 杂志文章

    doi:10.1177/000992289002900106

    authors: Schwartz RH,Wirtz PW

    更新日期:1990-01-01 00:00:00

  • Low frequency of meperidine-associated seizures in sickle cell disease.

    abstract::Pain control measures in sickle cell diseases are not uniform. Most clinicians use parenteral morphine or meperidine for severe pain. Reports of seizures associated with meperidine have led to a growing reliance on intravenous morphine, usually with patient-controlled devices. Acceptance of morphine has been poor amon...

    journal_title:Clinical pediatrics

    pub_type: 杂志文章

    doi:10.1177/000992289903800803

    authors: Nadvi SZ,Sarnaik S,Ravindranath Y

    更新日期:1999-08-01 00:00:00

  • Bacteremia in patients with cystic fibrosis.

    abstract::Bacteremia in patients with cystic fibrosis (CF) has not been previously reported, a fact probably attributable to activated systemic immunity in the presence of chronic bronchopulmonary infection. We have observed two CF patients under a year of age with documented bacteremia, and a teen-aged patient with autopsy evi...

    journal_title:Clinical pediatrics

    pub_type: 杂志文章

    doi:10.1177/000992288001901106

    authors: McCarthy MM,Rourk MH,Spock A

    更新日期:1980-11-01 00:00:00

  • Guide to early diagnosis of biliary obstruction in infancy. Review of 143 cases.

    abstract::Presenting characteristics, long-term outcome, and techniques used in the diagnosis of 143 infants with suspected biliary obstruction are reviewed. Sixty-nine patients had surgically confirmed extrahepatic disease and 74 had intrahepatic disorders. A disproportionate number of infants with intrahepatic disease were bo...

    journal_title:Clinical pediatrics

    pub_type: 杂志文章

    doi:10.1177/000992288502400601

    authors: Ferry GD,Selby ML,Udall J,Finegold M,Nichols B

    更新日期:1985-06-01 00:00:00

  • A view of Danish pediatric care.

    abstract::The Danish social system provides competent, accessible, continuous, and coordinated medical care to the pediatric population. The pediatrician does not deal with the routine aspects of well-infant and child care but is rather hospital based and acts on consultant to the generalists in his district. The generalist has...

    journal_title:Clinical pediatrics

    pub_type: 杂志文章

    doi:10.1177/000992287501400409

    authors: Maisel JE

    更新日期:1975-04-01 00:00:00

  • Accidental carbon monoxide poisoning.

    abstract::In this case report of an accidental automobile carbon monoxide poisoning, we identify the following risk factors: freezing temperature, young passenger age, location in the rear of the auto, smaller patient mass, and auto disrepair. The pathogenesis of carbon monoxide poisoning is reviewed. Emergency treatment and su...

    journal_title:Clinical pediatrics

    pub_type: 杂志文章

    doi:10.1177/000992288402301210

    authors: Zeller WP,Miele A,Suarez C,Hannigan J,Hurley RM

    更新日期:1984-12-01 00:00:00

  • How to Convince Parents to Stop Spanking Their Children.

    abstract::English- and Spanish-speaking parents of 1- to 5-year-old children were invited to view 5-10 minutes of parent training program, "Play Nicely," as part of the well-child checkup. Key measures were parents' plans to change how they discipline and, if they planned to use less spanking, how the program worked in their si...

    journal_title:Clinical pediatrics

    pub_type: 杂志文章

    doi:10.1177/0009922817693298

    authors: Hudnut-Beumler J,Smith A,Scholer SJ

    更新日期:2018-02-01 00:00:00

  • The capacity of primary care pediatricians to care for children with special health care needs.

    abstract:OBJECTIVE:To measure the willingness and ability of primary care pediatricians (PCPs) to accept children and youth with special health care needs (CYSHCN) into their practices. METHODS:Surveys were mailed to 1441 members of the Illinois Chapter of the American Academy of Pediatrics practicing primary care. RESULTS:In...

    journal_title:Clinical pediatrics

    pub_type: 杂志文章

    doi:10.1177/0009922813476572

    authors: Agrawal R,Shah P,Zebracki K,Sanabria K,Kohrman C,Kohrman AF

    更新日期:2013-04-01 00:00:00

  • Lyme arthritis presenting as transient synovitis of the hip.

    abstract::Transient synovitis of the hip is a common cause of hip pain in children. The etiology of transient synovitis of the hip is unknown. Lyme arthritis is characterized by brief, often recurrent episodes of oligoarthritis. Lyme arthritis most often affects a single knee, but hip involvement is uncommon. This report descri...

    journal_title:Clinical pediatrics

    pub_type: 杂志文章

    doi:10.1177/0009922808318337

    authors: Saulsbury FT

    更新日期:2008-10-01 00:00:00

  • Piloting group well child visits in pediatric resident continuity clinic.

    abstract:INTRODUCTION:Well child care is taught with individual visits in pediatric residency. Teaching residents how to deliver well child care efficiently is critical. Group well child care brings multiple families together for visits. The authors piloted group visits in pediatric residency clinic. METHODS:The authors conduc...

    journal_title:Clinical pediatrics

    pub_type: 杂志文章,随机对照试验

    doi:10.1177/0009922811417289

    authors: Saysana M,Downs SM

    更新日期:2012-02-01 00:00:00

  • Improving pediatrician knowledge about environmental triggers of asthma.

    abstract:BACKGROUND:Control of environmental triggers (ETs) greatly improves asthma outcomes in children. Disseminating these findings to general pediatricians has not been well established. METHODS:After delivering a structured and standardized presentation on ET identification and control to pediatricians, we surveyed them a...

    journal_title:Clinical pediatrics

    pub_type: 杂志文章,多中心研究

    doi:10.1177/0009922813482752

    authors: Roberts JR,Karr CJ,de Ybarrondo L,McCurdy LE,Freeland KD,Hulsey TC,Forman J

    更新日期:2013-06-01 00:00:00

  • Scleredema revisited. A poststreptococcal complication.

    abstract::Scleredema is a rare connective disease which must be differentiated from scleroderma in childhood. Scleredema is characterized by thickening of the dermis of the neck, head, and upper trunk. We report a case of scleredema in an 8-year-old boy with coincident streptococcal colonization. The patient report demonstrates...

    journal_title:Clinical pediatrics

    pub_type: 杂志文章,评审

    doi:10.1177/000992289403301006

    authors: Cron RQ,Swetter SM

    更新日期:1994-10-01 00:00:00

  • The perinatal infection of cytomegalovirus is an important etiology for biliary atresia in China.

    abstract:AIMS:The aims of this study were to detect the infection rates of DNA viruses in liver tissue of biliary atresia and to investigate the effect of perinatal infection of cytomegalovirus in biliary atresia. METHODS:A total of 85 liver biopsies (taken during Kasai portoenterostomy) were tested by fluorescence quantitativ...

    journal_title:Clinical pediatrics

    pub_type: 杂志文章

    doi:10.1177/0009922811406264

    authors: Xu Y,Yu J,Zhang R,Yin Y,Ye J,Tan L,Xia H

    更新日期:2012-02-01 00:00:00

  • Buprenorphine Overdose in Young Children: An Underappreciated Risk.

    abstract::The escalation of the opioid crisis has led to an increase in the treatment of opioid use disorder. In particular, recent legislation has allowed for office-based treatment with buprenorphine, a partial µ-opioid agonist that is believed to be safer than methadone due to a ceiling effect on respiratory depression in ad...

    journal_title:Clinical pediatrics

    pub_type: 杂志文章,评审

    doi:10.1177/0009922819829038

    authors: Lo Re M,Chaplin M,Aronow B,Modesto-Lowe V

    更新日期:2019-06-01 00:00:00

  • An approach to psychiatric referrals in pediatric patients. Psychosomatic complaints.

    abstract::Psychiatric referral is an important aspect of clinical pediatric practice. This paper discusses referral to a family-oriented psychiatrist of difficult families with children who have an acute or chronic psychosomatic complaint. It is the responsibility of primary care physicians to develop facility in making psychia...

    journal_title:Clinical pediatrics

    pub_type: 杂志文章

    doi:10.1177/000992288302200301

    authors: Hodas GR,Honig PJ

    更新日期:1983-03-01 00:00:00

  • Neonatal infrared axillary thermometry.

    abstract::The authors compared axillary skin temperatures (AT) measured with an infrared (IR) thermometer (Lightouch Neonate, Exergen Corp) with rectal temperatures (RT) in 16 newly born term infants under radiant warmers (RW) and in cribs. Twelve stable, growing premature infants in incubators were also studied. This new devic...

    journal_title:Clinical pediatrics

    pub_type: 杂志文章

    doi:10.1177/000992289903800105

    authors: Seguin J,Terry K

    更新日期:1999-01-01 00:00:00

  • Periodic use of inhaled steroids in children with mild persistent asthma: what are pediatricians recommending?

    abstract::Although asthma treatment guidelines recommend daily inhaled corticosteroid (ICS) use for all persistent asthma, pediatricians may recommend alternative treatment plans for children with mild persistent disease. The authors administered a survey of pediatricians to describe prescribing patterns for mild persistent ast...

    journal_title:Clinical pediatrics

    pub_type: 杂志文章

    doi:10.1177/0009922807312184

    authors: Sawicki GS,Smith L,Bokhour B,Gay C,Hohman KH,Galbraith AA,Lieu TA

    更新日期:2008-06-01 00:00:00

  • Work-related risk factors for hepatitis B virus infection in personnel of a children's hospital.

    abstract::Seroprevalence of hepatitis B virus markers was examined in employees participating in patient care at The Children's Mercy Hospital in Kansas City, Missouri. Of 377 workers tested in 1985-86, 36 (9.6%) were seropositive for any marker. Among 285 employees who presumably have only work-related hepatitis B exposure, 14...

    journal_title:Clinical pediatrics

    pub_type: 杂志文章

    doi:10.1177/000992288902800601

    authors: Hicks RA,Cullen JW,Jackson MA,Burry VF

    更新日期:1989-06-01 00:00:00

  • Infectious episodes following diphtheria-pertussis-tetanus vaccination. A preliminary observation in infants.

    abstract::Eighty two infants, aged 2-12 months, were prospectively studied for infectious episodes following diphtheria-pertussis-tetanus (DPT) immunization. The occurrence of infectious episodes during the month following vaccination was compared to that during the month prior to its administration. The 3 days following vaccin...

    journal_title:Clinical pediatrics

    pub_type: 杂志文章

    doi:10.1177/000992288802701005

    authors: Jaber L,Shohat M,Mimouni M

    更新日期:1988-10-01 00:00:00

  • Parental Knowledge and Attitudes About Universal Lipid Screening Among Children Aged 9 to 11 Years.

    abstract::Nationally recommended universal lipid screening (ULS) in children aged 9 to 11 years is low. Little is known about parents' understanding of screening. We conducted a survey exploring parental knowledge and attitudes regarding ULS. Of 91 parent respondents, 81.3% were female, 69.2% were non-Hispanic white, 90.1% had ...

    journal_title:Clinical pediatrics

    pub_type: 杂志文章

    doi:10.1177/0009922820903043

    authors: Kern L,Eichberger L,Wang H,Lin T,Rhee KE

    更新日期:2020-05-01 00:00:00

  • Predicting the need for exchange transfusion in newborn infants. A comparison of five methods.

    abstract::The need for exchange transfusion was analyzed retrospectively using several different methods (total bilirubin binding capacity, birth weight, plasma protein level, and two published charts). These predictive methods were applied to 175 jaundiced infants for whom all the data were available and to 19 infants who were...

    journal_title:Clinical pediatrics

    pub_type: 杂志文章

    doi:10.1177/000992288302200801

    authors: Robertson AF,Karp WB,Davis HC,Catterton WZ,Bunyapen C

    更新日期:1983-08-01 00:00:00

  • Presentation of pediatric celiac disease in the United States: prominent effect of breastfeeding.

    abstract::Childhood celiac disease (CD) is considered rare in the United States. Consequently there are few data concerning its clinical presentation. A validated questionnaire was distributed to families of children with CD. One hundred forty-one children with biopsy-proven CD were included in the study. We found significant d...

    journal_title:Clinical pediatrics

    pub_type: 杂志文章

    doi:10.1177/000992280504400309

    authors: D'Amico MA,Holmes J,Stavropoulos SN,Frederick M,Levy J,DeFelice AR,Kazlow PG,Green PH

    更新日期:2005-04-01 00:00:00

  • Comparison of urine dipstick, microscopy, and culture for the detection of bacteriuria in children.

    abstract::The authors compared dipstick tests for leukocyte esterase and nitrite and microscopic examination of urinary sediment with urine culture to assess whether the former tests could reliably rule out bacteriuria in specimens from children. The authors studied urine specimens from 1010 infants and children younger than ag...

    journal_title:Clinical pediatrics

    pub_type: 杂志文章

    doi:10.1177/000992289002900402

    authors: Goldsmith BM,Campos JM

    更新日期:1990-04-01 00:00:00

  • Influence of breast-feeding on mental and psychomotor development.

    abstract::The purpose of this study was to analyze the effects of breast-feeding on cognitive and motor development. A prospective cohort study was carried out enrolling 249 babies from 2 rural and urban areas. Cognitive development was assessed at the age of 18 months. Results show that adjusted scores on the mental developmen...

    journal_title:Clinical pediatrics

    pub_type: 杂志文章

    doi:10.1177/000992280304200106

    authors: Gómez-Sanchiz M,Cañete R,Rodero I,Baeza JE,Avila O

    更新日期:2003-01-01 00:00:00