ArticlePediatrics2017
Variability in Antibiotic Prescribing for Community-Acquired Pneumonia.
Article in Pediatrics, 2017. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 33 papers, 2 of them syntheses that pooled it.
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The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
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Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
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Who cites it
33 citing papers in PubMed, 2 syntheses or guidelines pooled it, 82 citations in OpenAlex.
- Short- versus long-course antibiotic therapy in non-severe CAP in children: a systematic review and meta-analysis.European journal of pediatrics · 2026Pooled it
- Factors Associated With Pneumonia Severity in Children: A Systematic Review.Journal of the Pediatric Infectious Diseases Society · 2018Pooled it
- Current Practice in the Diagnosis and Management ofJournal of Korean medical science · 2026Article
- Clinical Pathway Revision Increases Amoxicillin Monotherapy and 5-Day Durations of Therapy for Pediatric Community-Acquired Pneumonia in the Emergency Department and Urgent Care: A Quality Improvement Initiative.Annals of emergency medicine · 2025Article
- Antibiotic prescribing practices for acute otitis media and community-acquired pneumonia in a pediatric emergency department.Paediatrics & child health · 2025Article
- Re-evaluation of penicillin and ceftriaxone MIC results to predict susceptibility to the oral cephalosporin, cefpodoxime, inJournal of clinical microbiology · 2025Article
- Antimicrobial prescribing practices for enteric bacterial infections in an integrated health care system, Wisconsin, 2004-2017.Journal of infection and public health · 2025Article
- Plasma levels of neurogenic inflammation related neuropeptides in pediatric patients with community-acquired pneumonia and their potential diagnostic value in distinguishing viral and bacterial pneumonia.European journal of pediatrics · 2024Article
- Quality of antibiotic prescribing for pediatric community-acquired Pneumonia in outpatient care.BMC pediatrics · 2023Article
- Antibiotic Prescribing for Lower Respiratory Tract Infections and Community-Acquired Pneumonia: An Italian Pediatric Emergency Department's Real-Life Experience.Life (Basel, Switzerland) · 2023Article
- A scoping review and behavioural analysis of factors underlying overuse of antimicrobials.JAC-antimicrobial resistance · 2023Article
- Trends inOpen forum infectious diseases · 2023Article
- Validation of Prediction Models for Pneumonia Among Children in the Emergency Department.Pediatrics · 2022Article
- Rural-urban differences in antibiotic prescribing for uncomplicated urinary tract infection.Infection control and hospital epidemiology · 2021Observational
- Does procalcitonin have clinical utility in the management of paediatric community-acquired pneumonia? A PRO/CON debate.JAC-antimicrobial resistance · 2021Review
- Macrolides (alone or in combination) should be used as first-line empirical therapy of community-acquired pneumonia in children: myth or maxim?Breathe (Sheffield, England) · 2021Article
- Predicting Oral Beta-lactam susceptibilities against Streptococcus pneumoniae.BMC infectious diseases · 2021Article
- Combined influence of practice guidelines and prospective audit and feedback stewardship on antimicrobial treatment of community-acquired pneumonia and empyema in children: 2012 to 2016.Paediatrics & child health · 2021Article
- Rurality of Residence and Inappropriate Antibiotic Use for Acute Respiratory Infections Among Young Tennessee Children.Open forum infectious diseases · 2021Article
- Physician and patient perceptions of fecal microbiota transplant for recurrent or refractoryJGH open : an open access journal of gastroenterology and hepatology · 2020Article
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Authors and funding
5 authors at 4 institutions in 1 country.
Funding
Abstract
BACKGROUND AND
objectivesPublished guidelines recommend amoxicillin for most children with community-acquired pneumonia (CAP), yet macrolides and broad-spectrum antibiotics are more commonly prescribed. We aimed to determine the patient and clinician characteristics associated with the prescription of amoxicillin versus macrolide or broad-spectrum antibiotics for CAP.
methodsRetrospective cohort study in an outpatient pediatric primary care network from July 1, 2009 to June 30, 2013. Patients prescribed amoxicillin, macrolides, or a broad-spectrum antibiotic (amoxicillin-clavulanic acid, cephalosporin, or fluoroquinolone) for CAP were included. Multivariable logistic regression models were implemented to identify predictors of antibiotic choice for CAP based on patient- and clinician-level characteristics, controlling for practice.
resultsOf 10 414 children, 4239 (40.7%) received amoxicillin, 4430 (42.5%) received macrolides and 1745 (16.8%) received broad-spectrum antibiotics. The factors associated with an increased odds of receipt of macrolides compared with amoxicillin included patient age ≥5 years (adjusted odds ratio [aOR]: 6.18; 95% confidence interval [CI]: 5.53-6.91), previous antibiotic receipt (aOR: 1.79; 95% CI: 1.56-2.04), and private insurance (aOR: 1.47; 95% CI: 1.28-1.70). The predicted probability of a child being prescribed a macrolide ranged significantly between 0.22 and 0.83 across clinics. The nonclinical characteristics associated with an increased odds of receipt of broad-spectrum antibiotics compared with amoxicillin included suburban practice (aOR: 7.50; 95% CI: 4.16-13.55) and private insurance (aOR: 1.42; 95% CI: 1.18-1.71).
conclusionsAntibiotic choice for CAP varied widely across practices. Factors unlikely related to the microbiologic etiology of CAP were significant drivers of antibiotic choice. Understanding drivers of off-guideline prescribing can inform targeted antimicrobial stewardship initiatives.
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Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.