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Updated: Jul 28, 2025

Multiplex Therapeutic Drug Monitoring by Isotope-dilution HPLC-MS/MS of Antibiotics in Critical Illnesses
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Multiplex Therapeutic Drug Monitoring by Isotope-dilution HPLC-MS/MS of Antibiotics in Critical Illnesses

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Benchmarking of Outpatient Pediatric Antibiotic Prescribing: Results of a Multicenter Collaborative

Rana E El Feghaly1,2, Joshua C Herigon1,2, Matthew P Kronman3,4

  • 1Department of Pediatrics, Children's Mercy Kansas City, Kansas, Missouri, USA.

Journal of the Pediatric Infectious Diseases Society
|June 1, 2023
PubMed

Insights

Pediatric outpatient antibiotic use varies by setting, with urgent care centers showing the highest prescribing rates for acute respiratory infections. This study establishes national benchmarks for outpatient antibiotic stewardship in children.

Area of Science:

  • Pediatric Infectious Diseases
  • Antimicrobial Stewardship
  • Health Services Research

Background:

  • Most antibiotic prescriptions are issued in outpatient settings, yet pediatric institutions lack benchmarks for outpatient antibiotic use.
  • Assessing and comparing outpatient antibiotic prescribing rates among pediatric institutions is crucial for effective stewardship.

Purpose of the Study:

  • To establish national benchmarks for pediatric outpatient antibiotic use.
  • To share reports and metrics on antibiotic prescribing patterns in pediatric ambulatory care settings.

Main Methods:

  • Data collected from 21 pediatric institutions participating in the Sharing Antimicrobial Reports for Pediatric Stewardship OutPatient (SHARPS-OP) Collaborative from January 2019 to June 2022.
  • Metrics included antibiotic prescription rates for all acute encounters and acute respiratory infection (ARI) encounters.
  • Key performance indicators included the Amoxicillin index, Azithromycin index, and antibiotic prescription duration.

Main Results:

  • Urgent care centers (UCC) had the highest percentage of ARI encounters with antibiotic prescriptions (40.2%), while telehealth had the lowest (19.1%).
  • The Amoxicillin index was highest in emergency departments (ED) (76.2%) and lowest in telehealth (55.8%).
  • Significant variation was observed in the duration of antibiotic prescriptions (≤7 days) across different settings.

Conclusions:

  • A national benchmarking platform for pediatric outpatient antibiotic use metrics has been developed.
  • The established data serve as a baseline for future antimicrobial stewardship improvement initiatives in pediatric care.
Abstract

Keywords:
benchmarkingmetricsoutpatient antimicrobial stewardshippediatric

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