Impact of Clinician Feedback Reports on Antibiotic Use in Children Hospitalized With Community-acquired Pneumonia.

Details

• Alternative Title:
  Clinical Infectious Diseases : An Official Publication of the Infectious Diseases Society of America, 2025, v. 80, no. 2: Impact of Clinician Feedback Reports on Antibiotic Use in Children Hospitalized With Community-acquired Pneumonia.
• Journal Article:
  Clinical Infectious Diseases : An Official Publication of the Infectious Diseases Society of America
• Personal Author:
  Chiotos, Kathleen ; Dutcher, Lauren ; Grundmeier, Robert W. ; Meyahnwi, Didien ; Lautenbach, Ebbing ; Neuhauser, Melinda M. ; Hicks, Lauri A. ; Hamilton, Keith W. ; Li, Yun ; Szymczak, Julia E. ; Muller, Brandi M. ; Congdon, Morgan ; Kane, Emily ; Hart, Jessica ; Utidjian, Levon ; Cressman, Leigh ; Jaskowiak-Barr, Anne ; Gerber, Jeffrey S.
• Description:
  Feedback reports summarizing clinician performance are effective tools for improving antibiotic use in the ambulatory setting, but the effectiveness of feedback reports in the hospital setting is unknown.
  
  Quasi-experimental study conducted between December 2021 and November 2023 within a pediatric health system measuring the impact of clinician feedback reports delivered by email and reviewed in a monthly meeting on appropriate antibiotic use in children hospitalized with community-acquired pneumonia (CAP). We used an interrupted time series analysis (ITSA) to estimate the immediate change and change over time in the proportion of CAP encounters adherent to validated metrics of antibiotic choice and duration, then used Poisson regression to estimate intervention effect as a risk ratio (RR).
  
  Preintervention, 213 of 413 (52%) encounters received the appropriate antibiotic choice and duration, which increased to 308 of 387 (80%) postintervention. The ITSA demonstrated an immediate 18% increase in the proportion of CAP encounters receiving both the appropriate antibiotic choice and duration (95% confidence interval CI: 3-33%), with no further change over time (-0.3% per month, 95% CI: -2%-2%). In the Poisson model adjusted for age, sex, race, season, site, and intensive care unit admission, the intervention was associated with a 32% increase in the rate of appropriate antibiotic choice and duration (RR 1.32, 95% CI: 1.12-1.56, P < .01). No difference in length of stay or revisits were detected postintervention.
  
  The intervention was associated with an increase in clinician adherence to antibiotic choice and duration recommendations for children hospitalized with CAP.
• Content Notes:
  Author manuscript
• Subjects:
  • Humans
  • Community-Acquired Infections
  • Anti-Bacterial Agents
  • Child
  • Male
  • Female
  • Child, Preschool
  • Pneumonia
  • Hospitalization
  • Infant
  More +
• Keywords:
  • community-acquired pneumonia
  • antimicrobial stewardship
  • feedback report
  • audit and feedback
  • antibiotic
• Source:
  Clinical Infectious Diseases : An Official Publication of the Infectious Diseases Society of America, 2025, v. 80, no. 2
• DOI:
  https://doi.org/10.1093/cid/ciae593
• ISSN:
  1058-4838 ; 1537-6591
• Pubmed ID:
  39656188
• Pubmed Central ID:
  PMC12120840
• Document Type:
  Text
• Funding:
  CC999999/ImCDC/Intramural CDC HHSUnited States/ ; Safety and Healthcare Epidemiology Prevention Research Development/ ; U.S. Centers for Disease Control and Prevention/
• Genre:
  Journal Article
• Pages in Document:
  263-270 (16 pdf pages)
• Volume:
  80
• Issue:
  2
• Download URL:
  https://stacks.cdc.gov/view/cdc/261868/cdc_261868_DS1.pdf
• File Type:
  [PDF - 1.25 MB]
• Collection(s):
  CDC Public Access
• Main Document Checksum:
  urn:sha-512:0e069188fc74513f3e0393bf8a4400d49100c3f0f89dfe02317aa30693c8d80ae827433d5a4c05a69a34b4fe65bc30935e6ec594f85a6cc09b7f47e03aac70cf