ArticleInfection control and hospital epidemiology2023
Appropriateness of antibiotic prescribing varies by clinical services at United States children's hospitals.
Article in Infection control and hospital epidemiology, 2023. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 3 papers.
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Who cites it
3 citing papers in PubMed, 2 citations in OpenAlex.
- Derivation and validation of clinical prediction models for viral etiologies of acute diarrhea in North American children presenting for emergency care.medRxiv : the preprint server for health sciences · 2026Article
- Antibiotic-induced gut microbiota dysbiosis in the PICU: mechanisms, clinical outcomes, and management strategies - a narrative review.Frontiers in immunology · 2026Review
- Optimal Pediatric Outpatient Antibiotic Prescribing.JAMA network open · 2024Article
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Authors and funding
6 authors at 5 institutions in 1 country.
Funding
No grant is acknowledged in the PubMed record.
Abstract
objectiveTo describe patterns of inappropriate antibiotic prescribing at US children's hospitals and how these patterns vary by clinical service.
designSerial, cross-sectional study using quarterly surveys.
settingSurveys were completed in quarter 1 2019-quarter 3 2020 across 28 children's hospitals in the United States.
participantsPatients at children's hospitals with ≥1 antibiotic order at 8:00 a.m. on institution-selected quarterly survey days.
methodsAntimicrobial stewardship physicians and pharmacists collected data on antibiotic orders and evaluated appropriateness of prescribing. The primary outcome was percentage of inappropriate antibiotics, stratified by clinical service and antibiotic class. Secondary outcomes included reasons for inappropriate use and association of infectious diseases (ID) consultation with appropriateness.
resultsOf 13,344 orders, 1,847 (13.8%) were inappropriate; 17.5% of patients receiving antibiotics had ≥1 inappropriate order. Pediatric intensive care units (PICU) and hospitalists contributed the most inappropriate orders (n = 384 and n = 314, respectively). Surgical subspecialists had the highest percentage of inappropriate orders (22.5%), and 56.8% of these were for prolonged or unnecessary surgical prophylaxis. ID consultation in the previous 7 days was associated with fewer inappropriate orders (15% vs 10%;
conclusionsInappropriate antibiotic use for hospitalized children persists and varies by clinical service. Across 28 children's hospitals, PICUs and hospitalists contributed the most inappropriate antibiotic orders, and surgical subspecialists' orders were most often judged inappropriate. Understanding service-specific prescribing patterns will enable antimicrobial stewardship programs to better design interventions to optimize antibiotic use.
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