Clinical pediatrics · 2019
Antibiotic Prescribing in Outpatient Children: A Cohort From a Clinical Data Warehouse.
СтатьяНазвание и аннотация: Перевод в очереди
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Grammatico-Guillon Leslie, Shea Kimberly, Jafarzadeh S Reza, Camelo Ingrid, Maakaroun-Vermesse Zoha, Figueira Marisol, Adams William G, Pelton Steve
Аннотация
AIM: To characterize antibiotic (ab) prescriptions in children.
METHODS: Evaluation of outpatient ab prescriptions in a 3-year cohort of children in primary care using a data warehouse (Massachusetts Health Disparities Repository) by comorbid conditions, demographics, and clinical indication.
RESULTS: A total of 15 208 children with nearly 120 000 outpatient visits were included. About one third had a comorbid condition (most commonly asthma). Among the 30 000 ab prescriptions, first-line penicillins and macrolides represented the most frequent ab (70%), followed by cephalosporins (16%). Comorbid children had 54.3 ab prescriptions/100 child-years versus 38.8 in children without comorbidity; ab prescription was higher in urinary tract infections (>60% of episodes), otitis, lower respiratory tract infections (>50%), especially in comorbid children and children under 2 year old. Ab prescriptions were significantly associated with younger age, emergency room visit, comorbid children, and acute infections.
DISCUSSION: A clinical data warehouse could help in designing appropriate antimicrobial stewardship programs and represent a potential assessment tool.
METHODS: Evaluation of outpatient ab prescriptions in a 3-year cohort of children in primary care using a data warehouse (Massachusetts Health Disparities Repository) by comorbid conditions, demographics, and clinical indication.
RESULTS: A total of 15 208 children with nearly 120 000 outpatient visits were included. About one third had a comorbid condition (most commonly asthma). Among the 30 000 ab prescriptions, first-line penicillins and macrolides represented the most frequent ab (70%), followed by cephalosporins (16%). Comorbid children had 54.3 ab prescriptions/100 child-years versus 38.8 in children without comorbidity; ab prescription was higher in urinary tract infections (>60% of episodes), otitis, lower respiratory tract infections (>50%), especially in comorbid children and children under 2 year old. Ab prescriptions were significantly associated with younger age, emergency room visit, comorbid children, and acute infections.
DISCUSSION: A clinical data warehouse could help in designing appropriate antimicrobial stewardship programs and represent a potential assessment tool.
Предметные рубрики MeSH
Ambulatory CareAnti-Bacterial AgentsAntimicrobial StewardshipChildChild, PreschoolCohort StudiesData WarehousingDrug PrescriptionsDrug UtilizationFemaleHumansInappropriate PrescribingInfantMaleMassachusettsMicrobial Sensitivity TestsOutpatientsRespiratory Tract InfectionsRetrospective StudiesUrinary Tract Infections