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American Academy of Pediatrics National Conference and Exhibition
October 13, 2014
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Education, revised order sets improved guideline adherence for treatment of CAP

SAN DIEGO — A quality improvement initiative that updated health care workers on prescribing patterns and revised order sets improved adherence to the Infectious Diseases Society of American guidelines for antibiotic use among children with community-acquired pneumonia, according to data presented here.

Sonal Kalburgi, DO, of Children’s National Health System in Washington, DC, and colleagues implemented a quality improvement initiative that included education conferences, Computer Physician Order Entry order set revisions and quarterly staff updates on prescribing patterns, in a community hospital. Researchers reviewed medical records for 251 pediatric patients diagnosed with pneumonia from August 2010, prior to IDSA guidelines on community-acquired pneumonia (CAP), to March 2014, 1 year after quality initiative implementation.

Sonal Kalburgi

Sonal Kalburgi

Prescribing patterns did not significantly change after the release of IDSA guidelines in 2011, according to researchers. However, ampicillin use at hospital admission increased from 1% at baseline to 56% (P<0.001) after educational conferences and order set revisions in March 2013. Ceftriaxone use decreased during the same time period, from 97% to 44% (P<0.001).

Ampicillin use increased and ceftriaxone use decreased in the ED, while amoxicillin use increased at discharge.

Average length of stay remained constant during the study period. Readmission rates decreased.

“In this quality improvement initiative, the use of order sets as a clinical decision support tool helped improve adherence to national guidelines for narrow-spectrum antibiotic therapy in pediatric community-acquired pneumonia, without an increase in average length of stay or readmission rates,” the researchers concluded.

For more information:

Kalburgi S. Abstract #23867. Presented at: 2014 AAP National Conference and Exhibition; Oct. 11-14; San Diego.

Disclosure: Kalburgi reports no relevant financial disclosures.