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Research Studies is a compilation of published research articles funded by AHRQ or authored by AHRQ researchers.
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1 to 6 of 6 Research Studies DisplayedOlmeda K, Trautner BW, Laytner L
Prevalence and predictors of using antibiotics without a prescription in a pediatric population in the United States.
This study assessed the prevalence of antibiotic use in children in the previous 12 months, storage of antimicrobials, and intended use of non-prescription antibiotics (professed intention for future non-prescription antibiotic use). A diverse sample of caregivers of children under 18 years were surveyed in English and Spanish at two safety net clinics in Texas from January 2021 to April 2022. There was an 82% response rate, with 17% surveyed in Spanish. Approximately 21% reported storing antibiotics in their home, specifically amoxicillin (n = 52), clindamycin (n = 10), cephalexin (n = 5), penicillin (n = 3), and trimethoprim/sulfamethoxazole (n = 3). Nearly 15% reported intention to give non-prescription antibiotics to their children, with three Spanish-speaking caregivers reporting giving non-prescription antibiotics to their child in the previous 12 months. Younger caregivers were associated with storage and intended use of non-prescription antibiotics.
AHRQ-funded; HS027869.
Citation: Olmeda K, Trautner BW, Laytner L .
Prevalence and predictors of using antibiotics without a prescription in a pediatric population in the United States.
Antibiotics 2023 Mar;12(3). doi: 10.3390/antibiotics12030491..
Keywords: Children/Adolescents, Antibiotics, Medication, Antimicrobial Stewardship
Chiotos K, Blumenthal J, Boguniewicz J
Antibiotic indications and appropriateness in the pediatric intensive care unit: a 10-center point prevalence study.
The purpose of this study was to describe indications and appropriateness of antibiotic orders in pediatric intensive care unit (PICU) patients. The study found that of 1462 patients admitted to participating PICUs, 58% had at least 1 antibiotic order, with 1277 antibiotic orders being reviewed. Common indications were empiric therapy for suspected bacterial infections without sepsis or septic shock, nonoperative prophylaxis, empiric therapy for sepsis or septic shock, community-acquired pneumonia, and post-operative prophylaxis. Appropriateness was evaluated for 985 orders for which an evidence-based heading for appropriateness could be created. Of these, 34% were categorized as inappropriate. Indications with the most orders classified as inappropriate were empiric therapy for suspected bacterial infection without sepsis or septic shock, sepsis or septic shock, CAP, ventilator-associated infections, and post-operative prophylaxis. The proportion of antibiotics classified as inappropriate differed across institutions.
AHRQ-funded; HS026393.
Citation: Chiotos K, Blumenthal J, Boguniewicz J .
Antibiotic indications and appropriateness in the pediatric intensive care unit: a 10-center point prevalence study.
Clin Infect Dis 2023 Feb 8; 76(3):e1021-e30. doi: 10.1093/cid/ciac698..
Keywords: Children/Adolescents, Intensive Care Unit (ICU), Antibiotics, Medication, Antimicrobial Stewardship, Sepsis
Chiotos K, Marshall D, Kellom K
Mixed-methods process evaluation of a respiratory-culture diagnostic stewardship intervention.
The purpose of this study was to perform an evaluation of a diagnostic stewardship initiative for respiratory culture in the healthcare setting within a pediatric intensive care unit (PICU) in a tertiary-care center. The study found that the frequency of culture collection per day of service differed among attending physicians, ranging from 2.2 to 27 cultures per 100 days. A total of 14 interviews were conducted, and 87 clinicians (response rate: 47%) along with 77 nurses or respiratory therapists (response rate: 17%) participated in the survey. There was a variation in clinicians' stated practices concerning culture ordering, which was influenced by both their specialty and their perception of the respiratory culture's usefulness. Additionally, group "default" practices, fear, and hierarchy affected the decision to order cultures. Obstacles to standardization encompassed concerns about missing a diagnosis and the conflict between standardized practices and individual judgment.
AHRQ-funded; HS026393.
Citation: Chiotos K, Marshall D, Kellom K .
Mixed-methods process evaluation of a respiratory-culture diagnostic stewardship intervention.
Infect Control Hosp Epidemiol 2023 Feb; 44(2):191-99. doi: 10.1017/ice.2022.299..
Keywords: Children/Adolescents, Diagnostic Safety and Quality, Antibiotics, Medication, Antimicrobial Stewardship, Intensive Care Unit (ICU)
Kronman MP, Hersh AL, Gerber JS
Identifying antimicrobial stewardship targets for pediatric surgical patients.
The authors examined the collective pool of all systemic antibiotics prescribed to children hospitalized for surgical conditions and identified common surgical conditions with highly variable and potentially unnecessary antibiotic use. They concluded that the use of vancomycin for pediatric cardiothoracic and neurosurgical patients, and broad-spectrum antipseudomonal agents for gastrointestinal surgery patients, represent potentially high-yield targets for stewardship efforts to reduce unnecessary antimicrobial use.
AHRQ-funded; HS023320.
Citation: Kronman MP, Hersh AL, Gerber JS .
Identifying antimicrobial stewardship targets for pediatric surgical patients.
J Pediatric Infect Dis Soc 2015 Dec;4(4):e100-8. doi: 10.1093/jpids/piv022.
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Keywords: Antibiotics, Antimicrobial Stewardship, Children/Adolescents, Children/Adolescents, Surgery
Smith MJ, Gerber JS, Hersh AL
Inpatient antimicrobial stewardship in pediatrics: a systematic review.
The purpose of this paper was to describe the clinical and economic outcomes associated with pediatric antimicrobial stewardship programs and other supplemental antimicrobial stewardship interventions. The authors concluded that the studies researched demonstrated reductions in antimicrobial utilization, cost, and prescribing errors with no apparent negative impact on patient safety.
AHRQ-funded; HS023320.
Citation: Smith MJ, Gerber JS, Hersh AL .
Inpatient antimicrobial stewardship in pediatrics: a systematic review.
J Pediatric Infect Dis Soc 2015 Dec;4(4):e127-35. doi: 10.1093/jpids/piu141.
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Keywords: Antimicrobial Stewardship, Children/Adolescents, Healthcare Costs, Patient-Centered Outcomes Research, Children/Adolescents
Morelli JJ, Hogan PG, Sullivan ML
Antimicrobial susceptibility profiles of Staphylococcus aureus isolates recovered from humans, environmental surfaces, and companion animals in households of children with community-onset Methicillin-Resistant S. aureus infections.
The study objective was to determine the antibiotic susceptibility profiles of Staphylococcus aureus isolates recovered from 110 households of children with community-onset methicillin-resistant S. aureus (MRSA) infections. It found that the S. aureus isolates were heterogeneous, although more than half were methicillin resistant. The highest proportion of MRSA was found in bathrooms.
AHRQ-funded; HS021736.
Citation: Morelli JJ, Hogan PG, Sullivan ML .
Antimicrobial susceptibility profiles of Staphylococcus aureus isolates recovered from humans, environmental surfaces, and companion animals in households of children with community-onset Methicillin-Resistant S. aureus infections.
Antimicrob Agents Chemother 2015 Oct;59(10):6634-7. doi: 10.1128/aac.01492-15.
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Keywords: Antimicrobial Stewardship, Methicillin-Resistant Staphylococcus aureus (MRSA), Children/Adolescents