Evidence map›Paper›PMID 37898747›Full record

ArticleBMC pediatrics2023

Quality of antibiotic prescribing for pediatric community-acquired Pneumonia in outpatient care.

Ariana Saatchi, Manon R Haverkate, Jennifer N Reid, Salimah Z Shariff, Marcus Povitz, David M Patrick, Michael Silverman, Andrew M Morris, James McCormack, Fawziah Marra

Open access · goldAbstract read
PubMed Full text at PMC Publisher
In one paragraph

Article in BMC pediatrics, 2023. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 3 papers.

0numbers the graph read from it
0cells of the map it votes in
3citing papers in PubMed
0.4field-weighted citation impact, top 32% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

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.

2 · The registry

The trial behind it

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.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

3 citing papers in PubMed, 2 citations in OpenAlex.

  1. Trial
  2. Article
  3. Article
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

10 authors at 5 institutions in 1 country.

Ariana SaatchiFaculty of Pharmaceutical Sciences, University of British Columbia, 2405 Wesbrook Mall, Vancouver, BC, V6T 1Z3, Canada.
Manon R HaverkateFaculty of Pharmaceutical Sciences, University of British Columbia, 2405 Wesbrook Mall, Vancouver, BC, V6T 1Z3, Canada.
Jennifer N ReidLondon Health Sciences Centre, ICES Western, Lawson Health Research Institute, London, ON, Canada.
Salimah Z ShariffLondon Health Sciences Centre, ICES Western, Lawson Health Research Institute, London, ON, Canada.
Marcus PovitzDepartment of Medicine, University of Calgary, Calgary, AB, Canada.
David M PatrickBritish Columbia Centre for Disease Control, Vancouver, BC, Canada.
Michael SilvermanFaculty of Medicine, University of Western Ontario, London, ON, Canada.
Andrew M MorrisSinai Health System, University Health Network and University of Toronto, Toronto, ON, Canada.
James McCormackFaculty of Pharmaceutical Sciences, University of British Columbia, 2405 Wesbrook Mall, Vancouver, BC, V6T 1Z3, Canada.
Fawziah MarraFaculty of Pharmaceutical Sciences, University of British Columbia, 2405 Wesbrook Mall, Vancouver, BC, V6T 1Z3, Canada. fawziah@mail.ubc.ca.
University of British Columbia · CALawson Health Research Institute · CAUniversity Health Network · CAUniversity of Calgary · CAWestern University · CA

Funding

CIHR 201809-408648
6 · The paper itself

Abstract

backgroundAntibiotics remain the primary treatment for community acquired pneumonia (CAP), however rising rates of antimicrobial resistance may jeopardize their future efficacy. With higher rates of disease reported in the youngest populations, effective treatment courses for pediatric pneumonia are of paramount importance. This study is the first to examine the quality of pediatric antibiotic use by agent, dose and duration.

methodsA retrospective cohort study included all outpatient/primary care physician visits for pediatric CAP (aged < 19 years) between January 1 2014 to December 31 2018. Relevant practice guidelines were identified, and treatment recommendations extracted. Amoxicillin was the primary first-line agent for pediatric CAP. Categories of prescribing included: guideline adherent, effective but unnecessary (excess dose and/or duration), under treatment (insufficient dose and/or duration), and not recommended. Proportions of attributable-antibiotic use were examined by prescribing category, and then stratified by age and sex. RESULT(S): A total of 42,452 episodes of pediatric CAP were identified. Of those, 31,347 (76%) resulted in an antibiotic prescription. Amoxicillin accounted for 51% of all prescriptions. Overall, 27% of prescribing was fully guideline adherent, 19% effective but unnecessary, 10% under treatment, and 44% not recommended by agent. Excessive duration was the hallmark of effective but unnecessary prescribing (97%) Macrolides accounted for the majority on non-first line agent use, with only 32% of not recommended prescribing preceded by a previous course of antibiotics. CONCLUSION(S): This study is the first in Canada to examine prescribing quality for pediatric CAP by agent, dose and duration. Utilizing first-line agents, and shorter-course treatments are targets for stewardship.

Indexed as

Community-Acquired InfectionsPneumoniaAmbulatory CareAmoxicillinAnti-Bacterial AgentsChildDrug PrescriptionsHumansPractice Patterns, Physicians'Retrospective StudiesAmoxicillinAnti-Bacterial AgentsAntimicrobialsAppropriate prescribingCommunity acquired PneumoniaOutpatient carePediatricsStewardship

Identifiers

PMID37898747
PMCPMC10612244
OpenAlexW4388002244

What OpenQuestion holds

Textmetadata
LicenceCC BY
Read underepoch 390

Registered trials

None linked

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.