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Pediatric patient dosages diverge from adults due to disparities in body surface area, total body water, and extracellular fluid per kilogram of body weight. The dosing regimen considers the variations in pharmacokinetics and pharmacology across distinct age groups, encompassing preterm newborns, infants, young children, older children, and adolescents. Calculation of pediatric patient doses is predicated on determining body surface area, which exhibits a superior correlation with the child's...
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Related Experiment Video

Updated: Mar 7, 2026

A Protocol to Characterize the Morphological Changes of Clostridium difficile in Response to Antibiotic Treatment
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The Use of a Computerized Provider Order Entry Alert to Decrease Rates of Clostridium difficile Testing in Young

Maribeth R Nicholson1, Peter N Freswick2, M Cecilia Di Pentima3

  • 11Division of Pediatric Gastroenterology,Hepatology,and Nutrition,Vanderbilt University Medical Center,Nashville,Tennessee.

Infection Control and Hospital Epidemiology
|February 22, 2017
PubMed
Summary

A computerized provider order entry (CPOE) alert significantly reduced Clostridioides difficile (C. difficile) testing in young children. This intervention decreased unnecessary C. difficile testing without any complications in infants and toddlers.

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Area of Science:

  • Infectious Disease Epidemiology
  • Clinical Informatics
  • Pediatric Healthcare

Background:

  • Infants and young children are often colonized with Clostridioides difficile (C. difficile) but rarely develop symptomatic illness.
  • Despite low disease prevalence, C. difficile testing is common in pediatric populations.
  • Over-testing contributes to healthcare costs and potential for misdiagnosis.

Purpose of the Study:

  • To implement and evaluate a computerized provider order entry (CPOE) alert to reduce C. difficile testing in infants and young children.
  • To align C. difficile diagnostic practices with American Academy of Pediatrics recommendations.
  • To assess the impact of the CPOE alert on testing rates and patient outcomes.

Main Methods:

  • An interventional, age-targeted before-and-after trial was conducted.
  • A CPOE alert was implemented, advising against C. difficile testing in children under 36 months, with an optional override.
  • Educational seminars were provided to healthcare providers regarding appropriate C. difficile testing guidelines.

Main Results:

  • The monthly C. difficile testing rate decreased significantly for children aged 0-11 months (11.5 to 0 per 10,000 patient-days) and 12-35 months (61.6 to 30.1 per 10,000 patient-days).
  • No significant change in testing rates was observed for children aged 36 months and older, who were not targeted by the alert.
  • No complications were reported in children who tested positive for C. difficile.

Conclusions:

  • A CPOE alert effectively reduced C. difficile testing rates in children under 35 months old.
  • The intervention demonstrated a significant decrease in unnecessary diagnostic procedures without adverse events.
  • CPOE alerts are a valuable tool for optimizing C. difficile testing strategies in pediatric settings.