Evidence map›Paper›PMID 40778604›Full record

ArticlePediatric pulmonology2025

Quantifying Antibiotic Prescribing in Children With Tracheostomies.

Rebecca Steuart, Austin Slone, Joshua Courter, Dan Benscoter, Amy Y Pan, Samir S Shah, Joanna Thomson

Abstract read
In one paragraph

Article in Pediatric pulmonology, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 4 papers.

0numbers the graph read from it
0cells of the map it votes in
4citing papers in PubMed
–field-weighted citation impact
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

4 citing papers in PubMed.

  1. Article
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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

7 authors.

Rebecca SteuartDepartment of Pediatrics, Section of Complex Care, Medical College of Wisconsin, Milwaukee, Wisconsin, USA.ORCID https://orcid.org/0000-0002-5973-475X
Austin SloneUniversity of Cincinnati College of Medicine, Cincinnati, Ohio, USA.
Joshua CourterCincinnati Children's Hospital Medical Center, Division of Pharmacy, Cincinnati, Ohio, USA.
Dan BenscoterCincinnati Children's Hospital Medical Center, Division of Pulmonary Medicine, Cincinnati, Ohio, USA.
Amy Y PanDivision of Bioinformatics and Quantitative Child Health, Medical College of Wisconsin, Milwaukee, Wisconsin, USA.
Samir S ShahDepartment of Pediatrics, University of Cincinnati, Cincinnati, Ohio, USA.
Joanna ThomsonDepartment of Pediatrics, University of Cincinnati, Cincinnati, Ohio, USA.

Funding

Clinical and Translational Science AwardUL1TR001436 · NCATS · MEDICAL COLLEGE OF WISCONSIN · PI FREED, JULIE K · 2015 to 2025
$47.5M
Ruth L. Kirschstein National Research Service Award Short-Term Institutional ReseT35HL113229 · NHLBI · CINCINNATI CHILDRENS HOSP MED CTR · PI Raouf S. Amin, WILLIAM DAVID HARDIE · 2012 to 2026
$922k
AHRQ HHS K08 HS025138Dr. Steuart was supported by The Gerber Foundation under a Novice Researcher Award and the National Center for Advancing Translational Sciences, National Institutes of Health, Award Number UL1 TR001436. Mr. Slone was supported by the National Institutes of Health under award number 1T35HL113229-02. The content is solely the responsibility of the authors and does not necessarily represent the official views of the NIH. Dr. Thomson was supported by the Agency for Healthcare Research and Quality under award number K08HS025138.NCATS NIH HHS UL1 TR001436NHLBI NIH HHS T35 HL113229
6 · The paper itself

Abstract

objectivesTo quantify and characterize systemic antibiotic prescribing among children with tracheostomies, and to identify predictors of higher prescribing. STUDY

designThis single-center retrospective cohort study included children with tracheostomies 2 months-18 years old cared for at a quaternary care pediatric institution between 2010 and 2018. Antibiotics prescribed for >1 day were recorded, classified by spectrum of activity, and stratified by setting and year. Presumptively prophylactic antibiotics were excluded. Child-level antibiotic prescribing was quantified using number of courses and days of therapy (DOT) per child per year. Group-level prescribing was summarized using total courses and DOT per 1000 person-days and analyzed by year over study course. Predictors of child-level prescribing were identified using backward elimination multivariable analyses within a generalized linear model.

resultsThe 548 children with tracheostomies were prescribed a median four antibiotic courses per child per year (IQR: 1.9-10.0) for a total median exposure of 33.8 DOT per child per year (IQR: 16.1-71.6). The group was prescribed 100.7 DOT per 1000 person-days. Most courses (72.7%) were broad-spectrum, with vancomycin, piperacillin-tazobactam, and ampicillin-sulbactam/ampicillin-clavulanate being the most frequently prescribed courses. Annual antibiotic prescribing decreased 30%-33% between 2010 and 2018. Child ventilator use at baseline was associated with fewer DOT per child per year, while higher complexity and more ICU hospital days were risk factors for higher DOT.

conclusionChildren with tracheostomies have high systemic antibiotic use and are predominantly prescribed broad-spectrum antibiotics. Chronic ventilator use was associated with lower prescribing. These data may inform antimicrobial stewardship work.

Indexed as

Anti-Bacterial AgentsDrug PrescriptionsPractice Patterns, Physicians'TracheostomyAdolescentChildChild, PreschoolFemaleHumansInfantMaleRetrospective StudiesAnti-Bacterial Agentsantibiotic prescribingantibiotic utilizationantimicrobial stewardshipdays of therapytracheostomy

Identifiers

PMID40778604
PMCPMC12512247

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Registered trials

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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.