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Order set improves antibiotic treatment adherence for CAP

WASHINGTON — Adding an order set for the treatment of children admitted to the hospital with community-acquired pneumonia significantly narrowed the spectrum of antibiotics prescribed and improved imaging recommendation adherence, according to data presented at the 2015 AAP National Conference and Exhibition.

“We took an order set and implemented it, and tried to make it as easy, simple and user-friendly as possible; something that could be used in the ED as well as on inpatient services,” Jennifer A. Reed, MD, of the Sanford School of Medicine, Sioux Falls, South Dakota, told Infectious Diseases in Children. “We took kids getting the recommended antibiotic for pneumonia from 30% to 80% [compliance], with something so simple and cost effective – it helped everyone’s lives rather than adding clicks, buttons and extra things to do.”

Jennifer A. Reed

In an effort to improve compliance with guidelines for antibiotic administration and use of imaging and oxygen therapy among children presenting with community-acquired pneumonia, the researchers developed an order set based on current recommendations. A total of 25 patient charts from a single center were reviewed for the nine month period prior to the introduction of the order set, between July 2012 and April 2013.

After allowing six months for the implementation of the intervention, the researchers then followed-up with another nine month review of 38 patient charts, between October 2013 and June 2014.

Study findings showed that the order set significantly improved adherence to the antibiotic and imaging recommendations. Antibiotic compliance exhibited a 32% compliance rate prior to the intervention compared with 82% after the order set was implemented (P < .001). Likewise, imaging compliance improved from 88%, before the intervention, to 100% in the post-intervention period (P = .03).

The researchers concluded that the order set is a simple and effective way to improve compliance and could represent a substantial benefit for hospitals without antibiotic stewardship programs.

“This order set made a big difference in decreasing the antibiotic spectrum that we are using and increased use of more appropriate antibiotics for pneumonia treatment,” Reed said. – by David Costill

Reference:

Reed JA, et al. #29889. Presented at: 2015 AAP National Conference and Exhibition; Oct. 23-27; Washington D.C.

Disclosure: The researchers report no relevant financial disclosures.