Evidence map›Paper›PMID 38109895›Full record

ArticleJournal of the Pediatric Infectious Diseases Society2024

Implementation and Perceived Effectiveness of Prospective Audit and Feedback and Preauthorization by US Pediatric Antimicrobial Stewardship Programs.

Christina S Manice, Nivedita Muralidhar, Jeffrey I Campbell, Mari M Nakamura

Open access · greenAbstract read
In one paragraph

Article in Journal of the Pediatric Infectious Diseases Society, 2024. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 5 papers, 1 of them a synthesis that pooled it.

0numbers the graph read from it
0cells of the map it votes in
5citing papers in PubMed, 1 pooled it
1.3field-weighted citation impact, top 16% 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

5 citing papers in PubMed, 1 synthesis or guideline pooled it, 7 citations in OpenAlex.

  1. Pooled it
  2. Review
  3. Article
  4. Article
  5. Antimicrobial Stewardship in Pediatrics.Antibiotics (Basel, Switzerland) · 2024
    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

4 authors at 2 institutions in 1 country.

Christina S ManiceDivision of Pediatric Infectious Diseases, Boston Children's Hospital, Boston, Massachusetts, USA.ORCID 0000-0002-9426-9646
Nivedita MuralidharDivision of Pediatric Infectious Diseases, Boston Children's Hospital, Boston, Massachusetts, USA.
Jeffrey I CampbellDivision of Pediatric Infectious Diseases, Boston Medical Center, Boston, Massachusetts, USA.
Mari M NakamuraDivision of Pediatric Infectious Diseases, Boston Children's Hospital, Boston, Massachusetts, USA.ORCID 0000-0002-8191-0027
Boston Children's Hospital · USBoston University · US

Funding

Pediatric Infectious Diseases Research TrainingT32AI155391 · NIAID · BOSTON CHILDREN'S HOSPITAL · PI KIM, DENNIS H, WESSELS, MICHAEL R · 2021 to 2025
$1.3M
NIAID NIH HHS T32 AI155391NIH HHS 1T32AI155391-01A1
6 · The paper itself

Abstract

backgroundAntimicrobial stewardship programs (ASPs) promote optimal antimicrobial use to prevent resistance, improve outcomes, and reduce costs. We explored how pediatric ASPs enact prospective audit and feedback (PAF) and preauthorization and characterized programs' perceptions of how these choices affected attainment of stewardship goals.

methodsWe conducted focus groups with US pediatric ASP practitioners, organized by predominant strategy: PAF, preauthorization, or a hybrid. We asked open-ended questions about organization, staffing, and operation of these strategies, as well as rationales for and perceived advantages and disadvantages of these choices. We used applied thematic analysis to analyze transcripts, organizing coded text into themes and categories. We formulated a conceptual model for how the design and performance of PAF and preauthorization affect stewardship goals and stewards' work experiences.

resultsEighteen physicians and 14 pharmacists from 24 hospitals participated in five focus groups. Stewards described myriad advantages and limitations of PAF and preauthorization that support or detract from stewardship goals. For example, PAF uncovered institutional trends in antibiotic use and fostered relationship building but was time-consuming. Preauthorization efficiently reduced broad-spectrum antimicrobial use, yet offered limited educational opportunities. How these strategies facilitated or impeded appropriate antimicrobial use in turn affected stewards' professional satisfaction, creating a feedback loop that could reinforced positive or negative outcomes.

conclusionsASPs reported differing emphasis on and implementation of PAF and preauthorization. Each strategy entailed contrasting benefits and trade-offs for steward satisfaction and perceived efficacy, suggesting that a hybrid approach could enable ASPs to maximize strengths of each to mitigate drawbacks of the other.

Indexed as

Anti-Infective AgentsAntimicrobial StewardshipAnti-Bacterial AgentsChildFeedbackHospitalsHumansAnti-Bacterial AgentsAnti-Infective Agentsantimicrobial stewardshipfocus groupspreauthorizationprospective audit and feedback

Identifiers

PMID38109895
PMCPMC10896254
OpenAlexW4389958542

What OpenQuestion holds

Textmetadata
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.