دورية أكاديمية
Use of Clinical Practice Guideline to Improve Management of Osteoarticular Infections in Children.
| العنوان: | Use of Clinical Practice Guideline to Improve Management of Osteoarticular Infections in Children. |
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| المؤلفون: | Dimo J; Department of Pediatrics.; Department of Pediatrics, Division of Infectious Diseases, University of Colorado, Aurora, Colorado., Hahn D; Department of Pediatrics.; Department of Pediatrics, Division of Hospital Medicine., Schlidt K; Medical College of Wisconsin., Mobayed N; Medical College of Wisconsin., Dasgupta M; Department of Pediatrics, Division of Quantitative Health Sciences., Barbeau J; Department of Pediatrics, Division of Quantitative Health Sciences., Simpson PM; Department of Pediatrics, Division of Quantitative Health Sciences., Soung P; Department of Pediatrics.; Department of Pediatrics, Division of Hospital Medicine., Huppler AR; Department of Pediatrics.; Department of Pediatrics, Division of Infectious Diseases, Medical College of Wisconsin, Milwaukee, Wisconsin. |
| المصدر: | Hospital pediatrics [Hosp Pediatr] 2023 Jul 01; Vol. 13 (7), pp. 579-591. |
| نوع المنشور: | Journal Article |
| اللغة: | English |
| بيانات الدورية: | Publisher: American Academy of Pediatrics Country of Publication: United States NLM ID: 101585349 Publication Model: Print Cited Medium: Internet ISSN: 2154-1671 (Electronic) Linking ISSN: 21541671 NLM ISO Abbreviation: Hosp Pediatr Subsets: MEDLINE |
| أسماء مطبوعة: | Publication: July 2011- : Elk Grove Village : American Academy of Pediatrics Original Publication: Elk Grove Village, IL : American Academy of Pediatrics/Section on Hospital Medicine |
| مواضيع طبية MeSH: | Anti-Bacterial Agents* , Cephalosporins*/therapeutic use, Humans ; Child ; Patient Discharge |
| مستخلص: | Objectives: Osteoarticular infections (OAIs) in children pose significant risks if incorrectly managed. We introduced a clinical practice guideline (CPG) to decrease use of broad-spectrum and intravenous (IV) antibiotics for OAI treatment. The primary aims of our project were to decrease the percent of patients with empirical broad cephalosporin use to 10% and decrease IV antibiotic therapy on discharge to 20% while increasing narrow-spectrum oral antibiotic use to 80% within 24 months. Methods: We used quality improvement methodology to study patients diagnosed with OAIs. Interventions included multidisciplinary workgroup planning, CPG implementation, education, information technology, and stakeholder feedback. Outcome measures were the percentage of patients prescribed empirical broad-spectrum cephalosporins, percent discharged on IV antibiotics, and percent discharged on narrow-spectrum oral antibiotics. Process measures included percent of patients hospitalized on medicine service and infectious diseases consultation. Balancing measures included rates of adverse drug reactions, disease complications, length of stay, and readmission within 90 days. The impact of the interventions was assessed with run and control charts. Results: A total of 330 patients were included over 96 months. The percentage of patients with empirical broad cephalosporin coverage decreased from 47% to 10%, percent discharged on IV antibiotics decreased from 75% to 11%, and percent discharged on narrow-spectrum oral antibiotics increased from 24% to 84%. Adverse drug reactions decreased from 31% to 10%. Rates of complications, readmissions, and length of stay were unchanged. Conclusions: Through development and implementation of a CPG for OAI management, we demonstrated decreased use of empirical broad-spectrum antibiotics and improved definitive antibiotic management. (Copyright © 2023 by the American Academy of Pediatrics.) |
| المشرفين على المادة: | 0 (Anti-Bacterial Agents) 0 (Cephalosporins) |
| تواريخ الأحداث: | Date Created: 20230614 Date Completed: 20230703 Latest Revision: 20231116 |
| رمز التحديث: | 20240628 |
| DOI: | 10.1542/hpeds.2022-006822 |
| PMID: | 37313644 |
| قاعدة البيانات: | MEDLINE |
| تدمد: | 2154-1671 |
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| DOI: | 10.1542/hpeds.2022-006822 |