ArticleInfectious diseases and therapy2020
Ambulatory Antibiotic Prescribing for Children with Pneumonia After Publication of National Guidelines: A Cross-Sectional Retrospective Study.
Article in Infectious diseases and therapy, 2020. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 11 papers.
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Who cites it
11 citing papers in PubMed, 18 citations in OpenAlex.
- Global Antimicrobial Non-Susceptibility Patterns ofInfection and drug resistance · 2026Review
- Comparison of the effectiveness of penicillin and broad-spectrum β-lactam antibiotics in the treatment of community-acquired pneumonia in children.Archives of medical science : AMS · 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
- Antimicrobial prescribing practices for enteric bacterial infections in an integrated health care system, Wisconsin, 2004-2017.Journal of infection and public health · 2025Article
- Outpatient Antibiotic Use and Treatment Failure Among Children With Pneumonia.JAMA network open · 2024Article
- Trends inOpen forum infectious diseases · 2023Article
- Pathogen spectra in hospitalised and nonhospitalised children with community-acquired pneumonia.ERJ open research · 2023Article
- Impact of Penicillin Allergy Labels on Children Treated for Outpatient Respiratory Infections.Journal of the Pediatric Infectious Diseases Society · 2023Article
- 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
- Antibiotic Choice and Clinical Outcomes in Ambulatory Children with Community-Acquired Pneumonia.The Journal of pediatrics · 2021Article
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Authors and funding
4 authors at 3 institutions in 1 country.
Funding
No grant is acknowledged in the PubMed record.
Abstract
introductionNational guidelines published in 2011 recommend amoxicillin as first-line treatment for non-hospitalized children with community-acquired pneumonia (CAP). We aimed to understand visit rates, antibiotic selection, and factors associated with amoxicillin prescribing for children with CAP since guideline publication.
methodsWe performed a cross-sectional retrospective study of patients aged 90 days-18 years with an outpatient clinic or emergency department (ED) visit from 2008 to 2015 using the National Ambulatory Medical Care Survey and the National Hospital Ambulatory Medical Care Survey ED data files, respectively. We estimated the incidence rates of ambulatory CAP visits, examined time trends in antibiotics prescribed at CAP visits, and determined factors independently associated with first-line guideline-recommended antibiotic prescribing using multivariable logistic regression, including patient age, setting, and US census region.
resultsFrom 2008 to 2015, there were an estimated 1.5 million [95% confidence interval (CI) 1.3-1.7 million] pediatric CAP visits annually. Amoxicillin was prescribed in 23% (95% CI 18-30%), azithromycin was prescribed in 47% (95% CI 41-54%), and cephalosporins were prescribed in 26% (95% CI 21-31%) of antibiotic visits for CAP. There were no significant differences in annual CAP visits or prescribing by antibiotic class since guideline publication. Amoxicillin prescribing was significantly less likely in visits by older children, aged 5-18 years, [adjusted odds ratio (aOR) 0.22, 95% CI 0.10-0.49] compared to visits by younger children aged 90 days-4 years with CAP. Compared with the Northeast, amoxicillin prescribing was significantly lower in the Midwest (aOR 0.35, 95% CI 0.13-0.98) and South (aOR 0.23, 95% CI 0.08-0.63). Azithromycin prescribing was significantly more likely in visits to EDs (aOR 1.46, 95% CI 1.07-1.98) compared to physician offices.
conclusionDespite national guideline recommendations, amoxicillin prescribing for CAP in outpatient settings is low and azithromycin remains the predominant antibiotic prescribed, highlighting the need for dedicated antibiotic stewardship efforts in ambulatory settings.
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