Pediatric Antibiotic Prescribing Patterns From Emergency Department Visits

Area of Science:

• Pediatric Emergency Medicine
• Infectious Diseases
• Antimicrobial Stewardship

Background:

• Antibiotics are commonly prescribed for pediatric respiratory and genitourinary infections in emergency departments (EDs).
• Existing guidelines and antibiograms aim to optimize antibiotic selection, but provider adherence is not well-documented.

Purpose of the Study:

• To evaluate the adherence of pediatric ED providers to established guidelines and antibiograms for antibiotic prescribing.
• To assess trends in antibiotic use for pediatric respiratory and genitourinary infections over a six-year period.

Main Methods:

• Retrospective review of a national electronic medical record database from January 1, 2017, to December 31, 2022.
• Analysis included de-identified pediatric patients discharged from the ED with an antibiotic prescription.
• Antibiotics and infections were categorized, and prescribing patterns were analyzed annually.

Main Results:

• Over 85,000 pediatric patients and 24,000 antibiotic prescriptions were analyzed.
• Penicillin-based antibiotics increased for respiratory infections (76.5% to 81.3%), while cephalosporins rose for genitourinary infections (62.7% to 73.9%).
• Significant yearly increases in guideline-concordant prescribing were observed for both infection types (p < 0.001).

Conclusions:

• Pediatric ED providers demonstrated fair adherence to antibiotic guidelines for respiratory tract infections.
• Adherence to antibiogram-guided treatment for genitourinary tract infections improved significantly over the study period.
• These findings suggest a positive trend towards appropriate antibiotic use in pediatric emergency care.