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Pediatric providers report adherence to IDSA CAP guidelines
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BALTIMORE — Pediatric health care providers reported increased adherence to appropriate empiric therapy after the Infectious Diseases Society of America published its 2011 national guidelines for managing community-acquired pneumonia. The findings correspond with an observed change in practice at a tertiary care hospital, according to data presented at the Pediatric Academic Societies Meeting.
IDSA guidelines recommend using narrow antibiotic coverage with ampicillin or amoxicillin as a first-line therapy for uncomplicated community-acquired pneumonia (CAP), according to Karen Acker, MD, and Christine Salvatore, MD, of NewYork-Presbyterian/Weill Cornell Medical Center. To date, studies have demonstrated an increase in guideline compliance, but no changes in clinical outcomes.
Karen Acker
The researchers sought to assess the change in empiric antibiotic management of CAP since the publication of the IDSA CAP guidelines among patients aged 3 months to 22 years treated at a single tertiary care hospital. They identified CAP hospitalizations from November 2009 to November 2013 through administrative billing data then compared the use of guideline-compliant antibiotic therapy during pre-guideline (2009-2011) and post-guideline (2011-2013) periods. An anonymous survey was administered to pediatric hospitalists, pulmonologists, intensivists, and ED attendings to determine guideline awareness and perceived change in practice.
Of the 1,169 hospital visits for CAP, 310 were included in the analysis. The researchers compared 168 visits in the pre-guideline period with 142 visits in the post-guideline period and found the rate of guideline-compliant therapy increased from 11.8% to 20.8% in the ED and from 19% to 32.1% on admission (P = .0143).
Of the 29 health care providers who responded to the survey, 79% said they were aware of the 2011 IDSA guidelines for CAP. Ninety-one percent of those who reported guideline awareness reported a perceived change in clinical practice in accordance with the guidelines.
“With the increasing rate of antibiotic resistance in hospitals in the U.S. and worldwide, antibiotic stewardship is paramount in limiting the unnecessary use of broad-spectrum antibiotics,” Acker told Infectious Disease News. “Pediatric providers are increasing the use of narrow-spectrum antibiotics in the treatment of CAP since the publication of the IDSA guidelines, illustrating the importance of national guidelines in promoting antibiotic stewardship.” – by Stephanie Viguers
Reference: Acker K, et al. Abstract 2812.103. Presented at: Pediatric Academic Societies Meeting; April 30-May 3, 2016; Baltimore.
Disclosure: The researchers report no relevant financial disclosures.