National Healthcare Quality and Disparities Report
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AHRQ Research Studies Date
Topics
- Adverse Drug Events (ADE) (3)
- Adverse Events (1)
- Ambulatory Care and Surgery (2)
- (-) Antibiotics (40)
- Antimicrobial Stewardship (14)
- Asthma (2)
- Caregiving (1)
- Care Management (1)
- (-) Children/Adolescents (40)
- Chronic Conditions (2)
- Community-Acquired Infections (2)
- Critical Care (3)
- Decision Making (1)
- Diagnostic Safety and Quality (3)
- Ear Infections (1)
- Emergency Department (2)
- Evidence-Based Practice (1)
- Guidelines (1)
- Healthcare-Associated Infections (HAIs) (5)
- Healthcare Costs (1)
- Home Healthcare (1)
- Hospitalization (1)
- Imaging (1)
- Infectious Diseases (3)
- Intensive Care Unit (ICU) (5)
- Long-Term Care (1)
- Maternal Care (1)
- Medicaid (2)
- Medication (32)
- Medication: Safety (1)
- Methicillin-Resistant Staphylococcus aureus (MRSA) (5)
- Neurological Disorders (1)
- Newborns/Infants (1)
- Outcomes (1)
- Patient-Centered Outcomes Research (1)
- Patient Safety (4)
- Pneumonia (3)
- Practice Patterns (7)
- Pregnancy (1)
- Prevention (3)
- Primary Care (1)
- Respiratory Conditions (5)
- Risk (3)
- Screening (1)
- Sepsis (2)
- Sickle Cell Disease (1)
- Skin Conditions (3)
- Surgery (3)
- U.S. Preventive Services Task Force (USPSTF) (1)
- Urinary Tract Infection (UTI) (1)
- Women (1)
AHRQ Research Studies
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Research Studies is a compilation of published research articles funded by AHRQ or authored by AHRQ researchers.
Results
1 to 25 of 40 Research Studies DisplayedKeith A, Jenkins TC, O'Leary S
Reducing length of antibiotics for children with ear infections: protocol for a cluster-randomized trial in the USA.
The objective of the planned study described in this article will be to evaluate two low-cost interventions to increase guideline-concordant antibiotic durations in children with acute otitis media (AOM). The authors will explore differences in implementation effectiveness by patient population, clinician type, clinical setting, and organization as well as by intervention type. They will also conduct formative qualitative interviews with clinicians and administrators and focus groups with the parents of patients. The results of the study will provide a framework for healthcare systems to address the problem of excessive durations of therapy for AOM and to inform national antibiotic stewardship policy development.
AHRQ-funded; HS029153.
Citation: Keith A, Jenkins TC, O'Leary S .
Reducing length of antibiotics for children with ear infections: protocol for a cluster-randomized trial in the USA.
J Comp Eff Res 2023 Nov; 12(11):e230088. doi: 10.57264/cer-2023-0088..
Keywords: Children/Adolescents, Antibiotics, Medication, Ear Infections
Antoon JW, Grijalva CG, Carroll AR
Parental perceptions of penicillin allergy risk stratification and delabeling.
The purpose of this study was to explore parental perceptions of the PCN allergy evaluation and removal process, especially in the hospital setting. Investigators conducted focus groups consisting of parent of children and adolescents with a PCN allergy label discharged from a large academic children’s hospital between January 1, 2019, and April 15, 2020. The focus groups answered questions about PCN allergy testing and evaluation, accuracy of the PCN allergy diagnosis, amoxicillin oral challenges, delabeling process, and preferred setting for PCN allergy delabeling evaluation (outpatient clinic, hospital, etc). The study concluded family concerns remained even after children passed an oral challenge, and that some parents preferred testing in a hospital setting and thought it was a safer location for the procedure.
AHRQ-funded; HS026122.
Citation: Antoon JW, Grijalva CG, Carroll AR .
Parental perceptions of penicillin allergy risk stratification and delabeling.
Hosp Pediatr 2023 Apr; 13(4):300-08. doi: 10.1542/hpeds.2022-006737..
Keywords: Children/Adolescents, Antibiotics, Medication, Risk
Olmeda 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)
Woods-Hill CZ, Colantuoni EA, Koontz DW
Association of diagnostic stewardship for blood cultures in critically ill children with culture rates, antibiotic use, and patient outcomes: results of the Bright STAR Collaborative.
The purpose of this AHRQ-funded prospective study was to assess the relationship between a 14-site PICU blood culture collaborative, the Bright STAR (Testing Stewardship for Antibiotic Reduction) collaborative, and culture rates, antibiotic use, and patient outcomes. The researchers collected data from each participating PICU across the United States and from the Children’s Hospital Association Pediatric Health Information System. The main outcome was blood culture rates, with secondary outcomes including: broad-spectrum antibiotic use and PICU rates of central line-associated bloodstream infection (CLABSI), Clostridioides difficile infection, readmission, length of stay, sepsis, severe sepsis/septic shock, and mortality. The study found that the blood culture rate preimplementation across the 14 PICUs was 149.4 per 1000 patient days per month, and the rate postimplementation was 100.5 for a 33% relative reduction postimplementation. For those same periods, the rate of antibiotic use decreased from 506 days per 1000 patient-days per month preimplementation to 440 days per 1000 patient-days per month postimplementation, which reflects a 13% relative reduction. Rates of CLABSI decreased from 1.8 to 1.1 per 1000 central venous line days per month, a 36% relative reduction. The variables of length of stay, readmission, sepsis, severe sepsis/septic shock, and mortality were similar before and after implementation. The researchers concluded that collaborative interventions can reduce blood culture and antibiotic use in the PICU.
AHRQ-funded; HS025642.
Citation: Woods-Hill CZ, Colantuoni EA, Koontz DW .
Association of diagnostic stewardship for blood cultures in critically ill children with culture rates, antibiotic use, and patient outcomes: results of the Bright STAR Collaborative.
JAMA Pediatr 2022 Jul;176(7):690-98. doi: 10.1001/jamapediatrics.2022.1024..
Keywords: Children/Adolescents, Sepsis, Critical Care, Antibiotics, Medication, Diagnostic Safety and Quality, Antimicrobial Stewardship
Chiotos K, Fitzgerald JC, Hayes M
Improving vancomycin stewardship in critically ill children.
The purpose of this study was to describe a quality improvement intervention to reduce the use of vancomycin in a tertiary care Pediatric Intensive Care Unit. Over a period of 3 years, the researchers conducted 3 quality improvement (QI) interventions including 1) stakeholder education, 2) development of a consensus-based guideline for empiric vancomycin use, and 3) implementation of the guideline through clinical decision support. The study found that of 1276 episodes of suspected bacterial infection, a total of 19 cases of bacteremia (1.5%) due to organisms requiring vancomycin therapy were identified, including 6 MRSA bacteremias. Over the 3-year period of the QI project, overall vancomycin DOT per 1000 patient days in the PICU decreased from a baseline mean of 182 DOT per 1000 patient days to 109 DOT per 1000 patient days (a 40% reduction). The study concluded that the intervention reduced overall vancomycin use in the Pediatric Intensive Care Unit without evidence of harm.
AHRQ-funded; HS026393.
Citation: Chiotos K, Fitzgerald JC, Hayes M .
Improving vancomycin stewardship in critically ill children.
Pediatrics 2022 Apr;149(4):e2021052165. doi: 10.1542/peds.2021-052165..
Keywords: Children/Adolescents, Critical Care, Antimicrobial Stewardship, Antibiotics, Medication, Intensive Care Unit (ICU)
Isserman RS, Cheung J , Varallo D
Increasing cefazolin use for perioperative antibiotic prophylaxis in penicillin-allergic children.
The purpose of this quality improvement initiative was to increase the percentage of pediatric patients with non-severe penicillin-class allergies who receive cefazolin for antibiotic prophylaxis. The researchers included approximately 400 children in their multidisciplinary education-focused interventions, and through the initiative were able to increase the percent of eligible patients receiving cefazolin for antibiotic prophylaxis to 80%. The increase lasted through the project, and in the final month the study exceeded the study goal of 85%m with 90% of eligible patients receiving cefazolin. The researchers concluded that the initiative resulted in a considerable increase in the use of cefazolin for perioperative antibiotic prophylaxis in pediatric patients with penicillin allergies.
AHRQ-funded; HS026393.
Citation: Isserman RS, Cheung J , Varallo D .
Increasing cefazolin use for perioperative antibiotic prophylaxis in penicillin-allergic children.
Pediatrics 2022 Mar;149(3). doi: 10.1542/peds.2021-050694..
Keywords: Children/Adolescents, Antibiotics, Medication, Prevention
Malone S, McKay VR, Krucylak C
A cluster randomized stepped-wedge trial to de-implement unnecessary post-operative antibiotics in children: the optimizing perioperative antibiotic in children (OPerAtiC) trial.
This paper describes an upcoming clinical trial to determine best strategies to de-implement inappropriate antibiotic use in pediatric post-operative surgical cases deemed low risk for infection. This study will provide important information on the impact of two potential strategies while assessing important clinical outcomes.
AHRQ-funded; HS026742.
Citation: Malone S, McKay VR, Krucylak C .
A cluster randomized stepped-wedge trial to de-implement unnecessary post-operative antibiotics in children: the optimizing perioperative antibiotic in children (OPerAtiC) trial.
Implement Sci 2021 Mar 19;16(1):29. doi: 10.1186/s13012-021-01096-1..
Keywords: Children/Adolescents, Antimicrobial Stewardship, Antibiotics, Medication, Surgery
Neubauer HC, Hall M, Lopez MA
Antibiotic regimens and associated outcomes in children hospitalized with staphylococcal scalded skin syndrome.
Controversy exists regarding the optimal antibiotic regimen for use in hospitalized children with staphylococcal scalded skin syndrome (SSSS). Various regimens may confer toxin suppression and/or additional coverage for methicillin-susceptible Staphylococcus aureus (MSSA) or methicillin-resistant S aureus (MRSA). The purpose of this study was to describe antibiotic regimens in hospitalized children with SSSS and examine the association between antistaphylococcal antibiotic regimens and patient outcomes.
AHRQ-funded; HS026006.
Citation: Neubauer HC, Hall M, Lopez MA .
Antibiotic regimens and associated outcomes in children hospitalized with staphylococcal scalded skin syndrome.
J Hosp Med 2021 Mar;16(3):149-55. doi: 10.12788/jhm.3529..
Keywords: Children/Adolescents, Antibiotics, Medication, Methicillin-Resistant Staphylococcus aureus (MRSA), Skin Conditions, Infectious Diseases
Jones TW, Fino N, Olson J
The impact of beta-lactam allergy labels on hospitalized children.
Investigators sought to determine the impact of beta-lactam allergy labels in hospitalized children with regards to clinical and economic outcomes. Subjects were pediatric patients hospitalized at Intermountain Healthcare facilities from 2007 to 2017 who received one or more 1 dose of an antibiotic during their admission. The researchers found that patients with beta-lactam allergy received broader-spectrum antibiotics and experienced higher antibiotic costs than nonallergic controls. However, there were no differences in the length of stay, readmission rates, or total number of days of antibiotics between allergic and nonallergic patients.
AHRQ-funded; HS023320.
Citation: Jones TW, Fino N, Olson J .
The impact of beta-lactam allergy labels on hospitalized children.
Infect Control Hosp Epidemiol 2021 Mar;42(3):318-24. doi: 10.1017/ice.2020.424..
Keywords: Children/Adolescents, Antibiotics, Medication, Antimicrobial Stewardship
Turi KN, Gebretsadik T, Ding T
Dose, timing, and spectrum of prenatal antibiotic exposure and risk of childhood asthma.
The potential for prenatal antibiotic exposure to influence asthma risk is not clear. The investigators aimed to determine the effect of timing, dose, and spectrum of prenatal antibiotic exposure on the risk of childhood asthma. The investigators concluded that increased cumulative dose, early pregnancy first course, and broad-spectrum antibiotic exposure were associated with childhood asthma risk.
AHRQ-funded; HS026395; HS018454.
Citation: Turi KN, Gebretsadik T, Ding T .
Dose, timing, and spectrum of prenatal antibiotic exposure and risk of childhood asthma.
Clin Infect Dis 2021 Feb 1;72(3):455-62. doi: 10.1093/cid/ciaa085.
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Keywords: Children/Adolescents, Asthma, Respiratory Conditions, Antibiotics, Medication, Risk
Beltran Ale G, Benscoter D, Hossain MM
Impact of respiratory viral polymerase chain reaction testing on de-escalation of antibiotic therapy in children who require chronic positive pressure ventilation.
This study examined whether positive viral infection results stops antibiotic use in children who require chronic positive pressure ventilation (CPPV) who are frequently hospitalized with acute respiratory infections. A retrospective cohort study was conducted with 118 children on CPPV who had respiratory viral polymerase chain reaction (RVP) testing on admission. A viral pathogen was identified in 46.5% of the cases, with rhinovirus the most frequently identified. Antibiotic de-escalation occurred in only 33% of admissions and did not seem to impact antibiotic prescribing for hospitalized children on CPPV.
AHRQ-funded; HS012538.
Citation: Beltran Ale G, Benscoter D, Hossain MM .
Impact of respiratory viral polymerase chain reaction testing on de-escalation of antibiotic therapy in children who require chronic positive pressure ventilation.
Pediatr Pulmonol 2020 Aug;55(8):2150-55. doi: 10.1002/ppul.24884..
Keywords: Children/Adolescents, Respiratory Conditions, Antibiotics, Medication, Chronic Conditions
Thomson J, Hall M, Ambroggio L
Antibiotics for aspiration pneumonia in neurologically impaired children.
The objective of the study was to compare hospital outcomes associated with commonly used antibiotic therapies for aspiration pneumonia in children with neurologic impairment (NI). The investigators concluded that anaerobic therapy appeared to be important in the treatment of aspiration pneumonia in children with NI. They suggested that while Gram-negative coverage alone was associated with worse outcomes, its addition to anaerobic therapy may not yield improved outcomes.
AHRQ-funded; HS025138.
Citation: Thomson J, Hall M, Ambroggio L .
Antibiotics for aspiration pneumonia in neurologically impaired children.
J Hosp Med 2020 Jul;15(7):395-402. doi: 10.12788/jhm.3338..
Keywords: Children/Adolescents, Pneumonia, Respiratory Conditions, Neurological Disorders, Antibiotics, Medication, Outcomes
Malone SM, Seigel NS, Newland JG
Understanding antibiotic prophylaxis prescribing in pediatric surgical specialties.
The objective of this study was to understand the factors that contribute to pediatric surgeons' decisions regarding the use of perioperative antibiotic prophylaxis. The investigators found that surgeons described a complex set of factors that impacted their antibiotic prescribing in pediatric surgical cases. They reported initial, but not ongoing, training and a use of individual weight of risk and benefit as a major dictator of prescribing practices.
AHRQ-funded; HS026742.
Citation: Malone SM, Seigel NS, Newland JG .
Understanding antibiotic prophylaxis prescribing in pediatric surgical specialties.
Infect Control Hosp Epidemiol 2020 Jun;41(6):666-71. doi: 10.1017/ice.2020.71..
Keywords: Children/Adolescents, Antibiotics, Surgery, Antimicrobial Stewardship, Medication, Practice Patterns
Donovan BM, Abreo A, Ding T
Dose, timing, and type of infant antibiotic use and the risk of childhood asthma.
This study examined the association between dose, timing and type of infant antibiotic use and the risk of childhood asthma. The study examined a cohort of 152,622 children enrolled in the Tennessee Medicaid Program. At least 79% had at least one antibiotic prescription fill during infancy. There was a 20% increase in odds of childhood asthma for each additional antibiotic filled. There was no significant association between timing, formulation, anaerobic coverage and class of antibiotics and childhood asthma. However, broad spectrum antibiotic fills increased the odds of development of childhood asthma compared to narrow spectrum only fills.
AHRQ-funded; HS018454.
Citation: Donovan BM, Abreo A, Ding T .
Dose, timing, and type of infant antibiotic use and the risk of childhood asthma.
Clin Infect Dis 2020 Apr 10;70(8):1658-65. doi: 10.1093/cid/ciz448..
Keywords: Newborns/Infants, Children/Adolescents, Antibiotics, Medication, Asthma, Respiratory Conditions, Risk, Chronic Conditions
Kahwati LC, Clark R, Berkman N
Screening for bacterial vaginosis in pregnant adolescents and women to prevent preterm delivery: updated evidence report and systematic review for the US Preventive Services Task Force.
Researchers sought to update the evidence on screening and treatment of asymptomatic bacterial vaginosis in pregnancy for the USPSTF. They found that the evidence suggests no difference in the incidence of preterm delivery and related outcomes from treatment for asymptomatic bacterial vaginosis in a general obstetric population but was inconclusive for women with a prior preterm delivery. Maternal adverse events from treatment appear to be infrequent and minor, but the evidence about harms from in utero exposure was inconclusive.
AHRQ-funded; 290201500011I.
Citation: Kahwati LC, Clark R, Berkman N .
Screening for bacterial vaginosis in pregnant adolescents and women to prevent preterm delivery: updated evidence report and systematic review for the US Preventive Services Task Force.
JAMA 2020 Apr 7;323(13):1293-309. doi: 10.1001/jama.2020.0233..
Keywords: U.S. Preventive Services Task Force (USPSTF), Screening, Evidence-Based Practice, Prevention, Women, Children/Adolescents, Pregnancy, Maternal Care, Antibiotics, Medication
Fischer MA, Mahesri M, Lii J
Non-Infection-related and non-visit-based antibiotic prescribing is common among Medicaid patients.
This study examined antibiotic prescribing by clinicians when there was no visit or without clear indications for use. The authors discuss the fact that current ambulatory antibiotic stewardship policies do not capture prescribing outside of clinician visits or clear indications for use. They measured the frequency for all filled antibiotic prescriptions in Medicaid patients in the period 2004-2013. They found that out of 298 million antibiotic fills for 53 million patients (62% for children), 55% were for clinician visits with an infection-related diagnosis, 17% were for visits without an infection-related diagnosis, and 28% were not associated with a visit.
AHRQ-funded; HS024930; HS023236; HS024651; HS026506; 2332015000201.
Citation: Fischer MA, Mahesri M, Lii J .
Non-Infection-related and non-visit-based antibiotic prescribing is common among Medicaid patients.
Health Aff 2020 Feb;39(2):280-88. doi: 10.1377/hlthaff.2019.00545..
Keywords: Antimicrobial Stewardship, Medicaid, Antibiotics, Medication, Practice Patterns, Children/Adolescents
Woods-Hill CZ, Koontz DW, King AF
Practices, perceptions, and attitudes in the evaluation of critically ill children for bacteremia: a national survey.
Sending blood cultures in children at low risk of bacteremia can contribute to a cascade of unnecessary antibiotic exposure, adverse effects, and increased costs. In this study, the investigators aimed to describe practice variation, clinician beliefs, and attitudes about blood culture testing in critically ill children. They concluded that there is variation in blood culture practices in the pediatric ICU. Fear and reflexive habits are common drivers of cultures. These practices may contribute to over-testing for bacteremia.
AHRQ-funded; HS025642.
Citation: Woods-Hill CZ, Koontz DW, King AF .
Practices, perceptions, and attitudes in the evaluation of critically ill children for bacteremia: a national survey.
Pediatr Crit Care Med 2020 Jan;21(1):e23-e29. doi: 10.1097/pcc.0000000000002176..
Keywords: Children/Adolescents, Critical Care, Antimicrobial Stewardship, Antibiotics, Adverse Drug Events (ADE), Adverse Events, Patient Safety, Intensive Care Unit (ICU), Decision Making
Khamash DF, Voskertchian A, Tamma PD
Increasing clindamycin and trimethoprim-sulfamethoxazole resistance in pediatric Staphylococcus aureus Infections.
This retrospective observational study looked at pediatric clinical cultures between 2005 and 2017 that grew Staphylococcus aureus culture and their trends in antibiotic resistance. Methicillin resistance declined but clindamycin and trimethoprim-sulfamethoxazole resistance increased significantly.
AHRQ-funded; HS022872.
Citation: Khamash DF, Voskertchian A, Tamma PD .
Increasing clindamycin and trimethoprim-sulfamethoxazole resistance in pediatric Staphylococcus aureus Infections.
J Pediatric Infect Dis Soc 2019 Sep 25;8(4):351-53. doi: 10.1093/jpids/piy062..
Keywords: Children/Adolescents, Antibiotics, Medication, Healthcare-Associated Infections (HAIs), Infectious Diseases, Methicillin-Resistant Staphylococcus aureus (MRSA)
Khamash DF, Voskertchian A, Tamma PD
Increasing clindamycin and trimethoprim-sulfamethoxazole resistance in pediatric Staphylococcus aureus Infections.
This retrospective observational study looked at pediatric clinical cultures between 2005 and 2017 that grew Staphylococcus aureus culture and their trends in antibiotic resistance. Methicillin resistance declined but clindamycin and trimethoprim-sulfamethoxazole resistance increased significantly.
AHRQ-funded; HS022872.
Citation: Khamash DF, Voskertchian A, Tamma PD .
Increasing clindamycin and trimethoprim-sulfamethoxazole resistance in pediatric Staphylococcus aureus Infections.
J Pediatric Infect Dis Soc 2019 Sep 25;8(4):351-53. doi: 10.1093/jpids/piy062..
Keywords: Children/Adolescents, Healthcare-Associated Infections (HAIs), Antibiotics, Medication
Briscoe CC, Reich P, Fritz S
Staphylococcus aureus antibiotic susceptibility patterns in pediatric atopic dermatitis.
Researchers characterized Staphylococcus aureus strains recovered from pediatric atopic dermatitis patients with clinically apparent bacterial skin infections treated in an academic medical center. They conducted a five-year retrospective study to characterize the S aureus strains; patient demographics and dilute bleach bath usage were assessed to determine whether these factors were correlated with methicillin resistance. Culture results from the cohort were compared to those from pediatric patients presenting to a children's hospital emergency department with S aureus skin abscesses. The researchers concluded that first-generation cephalosporins remains an appropriate empiric therapy for most pediatric atopic dermatitis patients.
AHRQ-funded; HS021736; HS024269.
Citation: Briscoe CC, Reich P, Fritz S .
Staphylococcus aureus antibiotic susceptibility patterns in pediatric atopic dermatitis.
Pediatr Dermatol 2019 Jul;36(4):482-85. doi: 10.1111/pde.13867..
Keywords: Antibiotics, Children/Adolescents, Medication, Skin Conditions
Advanced Analytics Group of Pediatric Urology, ORC Personalized Medicine Group
Targeted workup after initial febrile urinary tract infection: using a novel machine learning model to identify children most likely to benefit from voiding cystourethrogram.
The authors sought to develop a model to predict the probability of recurrent urinary tract infection associated vesicoureteral reflux in children after an initial urinary tract infection. Their predictive model provided a promising performance to facilitate individualized treatment of children with an initial urinary tract infection and to identify those most likely to benefit from voiding cystourethrogram after the initial urinary tract infection. They conclude that this model would allow for more selective test application and increase yield while minimizing overuse.
AHRQ-funded; HS000063.
Citation: Advanced Analytics Group of Pediatric Urology, ORC Personalized Medicine Group .
Targeted workup after initial febrile urinary tract infection: using a novel machine learning model to identify children most likely to benefit from voiding cystourethrogram.
J Urol 2019 Jul;202(1):144-52. doi: 10.1097/ju.0000000000000186..
Keywords: Antibiotics, Care Management, Children/Adolescents, Guidelines, Medication, Urinary Tract Infection (UTI)
Krah NM, Bardsley T, Nelson R
Economic burden of home antimicrobial therapy: OPAT versus oral therapy.
There is increasing evidence that outpatient parenteral antimicrobial therapy (OPAT) is overused for children and that outcomes with oral therapy are equivalent. The objective of this study was to compare economic burden between OPAT and oral therapy, accounting for direct and indirect costs and caregiver quality of life (QoL). The investigators concluded that the overall burden of OPAT was substantially higher than that of oral therapy, including higher direct and indirect costs and greater impact on caregiver QoL.
AHRQ-funded; HS023320.
Citation: Krah NM, Bardsley T, Nelson R .
Economic burden of home antimicrobial therapy: OPAT versus oral therapy.
Hosp Pediatr 2019 Apr;9(4):234-40. doi: 10.1542/hpeds.201-0193.
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Keywords: Healthcare Costs, Children/Adolescents, Caregiving, Home Healthcare, Antimicrobial Stewardship, Antibiotics, Medication
Sick-Samuels AC, Woods-Hill CZ, Fackler JC
Association of a blood culture utilization intervention on antibiotic use in a pediatric intensive care unit.
The goal of this study was to evaluate whether the use of antibiotics at the Johns Hopkins pediatric intensive care unit (PICU) changed in relation to a reduction in utilization of blood culture. Antibiotic usage is used as a balancing measure, because a reduction in blood cultures could lead to an increase in antibiotic treatment if clinicians continued treatment in scenarios when blood culture results were not available. The authors examined the administration of antibiotics over 12 months while a locally developed blood-culture guideline was being implemented. The distribution of antibiotics remained similar over the pre- and post-implementation periods.
AHRQ-funded; HS025642.
Citation: Sick-Samuels AC, Woods-Hill CZ, Fackler JC .
Association of a blood culture utilization intervention on antibiotic use in a pediatric intensive care unit.
Infect Control Hosp Epidemiol 2019 Apr;40(4):482-84. doi: 10.1017/ice.2019.10..
Keywords: Antibiotics, Children/Adolescents, Intensive Care Unit (ICU), Medication, Practice Patterns