Trial reportPediatrics2026
Eliminating Inappropriate Postoperative Antibiotics: A Stepped-Wedge Cluster Randomized Trial.
Trial report in Pediatrics, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
What it found
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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.
The trial behind it
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Who cites it
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Corrections and comments
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Authors and funding
12 authors.
Funding
Abstract
backgroundUnnecessary postoperative antibiotic use is common. This study evaluated whether modifying electronic health record order sets plus participation in a facilitation workshop by the antimicrobial stewardship team reduced inappropriate postoperative antibiotic duration more than modifying order sets alone.
methodsA stepped-wedge cluster randomized trial compared order set modification (active control) vs order set modification plus facilitation (experimental) from November 1, 2020, to October 31, 2023, at 9 US children's hospitals. The primary outcome was the rate of inappropriate postoperative antibiotic duration of greater than 24 hours after incision closure. Secondary outcomes included inappropriate postoperative antibiotics, defined as any antibiotic use and the rate of surgical site infections (SSI) or Clostridioides difficile infections (CDI). Generalized estimating equations (GEEs) accounting for clustering at the step and hospital level were utilized to compare 2 groups.
resultsA total of 18 267 patients (5910 control, 12 357 experimental) were included, with a median age of 9.2 years (IQR 2-14), 50.6% of the female gender, and 58% with public insurance/self-pay. The primary outcome was lower in the experimental group (10.05%, (95% CI: 9.53-10.59) than the control (11.02%, 95% CI: 10.23-11.84, P = .05), but this difference was not apparent in the GEE analysis (P = .74). The secondary outcomes demonstrated no difference between control and experimental groups for any postoperative antibiotic use (45.1% vs 44.7%, P = .98), SSI (1.96% vs 2.03%, P = .70), and CDI (0.15% vs 0.06%, P = .85).
conclusionsFacilitation training did not reduce inappropriate postoperative antibiotic duration compared with order set modification; better understanding of how hospital context informs change strategies is needed.
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