Improving Use of Antibiotics for Pediatric Pneumonia in Community Hospital Emergency Departments

Area of Science:

• Pediatric Emergency Medicine
• Infectious Disease Management
• Quality Improvement Science

Background:

• Pediatric pneumonia is a common emergency department diagnosis.
• Current narrow-spectrum antibiotic prescribing for pediatric pneumonia falls below best practice guidelines.
• Community hospitals face challenges in optimizing antibiotic stewardship.

Purpose of the Study:

• To enhance the prescription of narrow-spectrum antibiotics for pediatric pneumonia in community hospital emergency departments.
• To implement an interdisciplinary learning collaborative to improve antibiotic prescribing practices.
• To achieve an 80% rate of narrow-spectrum antibiotic use by December 2018.

Main Methods:

• A quality improvement collaborative involving 5 community hospitals was established.
• Interventions included evidence-based guidelines, education, and order set modifications, utilizing Plan-Do-Study-Act cycles.
• Data were collected for 12 months pre-intervention, during the intervention, and for one year post-intervention, analyzed using statistical process control charts.

Main Results:

• Narrow-spectrum antibiotic prescription rates increased from 60% (baseline) to 78% during the intervention.
• Sustained improvement was observed, with rates reaching 92% in the year following active implementation.
• Improved prescribing was noted across both general emergency medicine and pediatric providers, with no increase in 72-hour return visits for treatment failure.

Conclusions:

• An interdisciplinary learning collaborative effectively improved narrow-spectrum antibiotic prescribing for pediatric pneumonia in community emergency departments.
• The collaborative model demonstrated sustained positive impact on antibiotic stewardship.
• This approach successfully engaged diverse provider types in optimizing treatment for pediatric pneumonia.