Impact of clinical decision support on empirical antibiotic prescribing for children with community-acquired pneumonia

Mostaghim, M; Snelling, T; McMullan, B; Ewe, YH; Bajorek, B

Impact of clinical decision support on empirical antibiotic prescribing for children with community-acquired pneumonia

Mostaghim, M

Snelling, T McMullan, B Ewe, YH Bajorek, B

Permalink

Publication Type:: Journal Article
Citation:: Journal of Paediatrics and Child Health, 2019, 55 (3), pp. 305 - 311
Issue Date:: 2019-03-01

Closed Access

	Filename	Description	Size
	Impact of clinical decision support on empirical antibiotic prescribing for children with community-acquired pneumonia.pdf	Published Version	253.95 kB	Adobe PDF	View/Open

Copyright Clearance Process

Recently Added
In Progress
Closed Access

This item is closed access and not available.

Full metadata record

Field	Value	Language
dc.contributor.author	Mostaghim, M https://orcid.org/0000-0001-9918-7765	en_US
dc.contributor.author	Snelling, T	en_US
dc.contributor.author	McMullan, B	en_US
dc.contributor.author	Ewe, YH	en_US
dc.contributor.author	Bajorek, B https://orcid.org/0000-0002-2532-7187	en_US
dc.date.available	2018-07-08	en_US
dc.date.issued	2019-03-01	en_US
dc.identifier.citation	Journal of Paediatrics and Child Health, 2019, 55 (3), pp. 305 - 311	en_US
dc.identifier.issn	1034-4810	en_US
dc.identifier.uri	http://hdl.handle.net/10453/135447
dc.description.abstract	© 2018 Paediatrics and Child Health Division (The Royal Australasian College of Physicians) Aim: To assess the impact of a computerised clinical decision support system (CDSS) on antibiotic use in hospitalised children with a presumptive diagnosis of uncomplicated community-acquired pneumonia (CAP). Methods: Codes associated with lower respiratory tract infection were used to identify cases of presumed uncomplicated CAP requiring admission to a tertiary paediatric hospital. Random sampling of the periods between 1 October 2010 and 30 September 2012 (pre-CDSS) and 1 October 2012 and 30 September 2014 (post-CDSS) determined the sequence of case assessment by two independent investigators. Initial antibiotic therapy, associated CDSS approvals and documented signs of clinical deterioration prior to antibiotic decision-making were recorded. Results: Statistically significant differences between cases pre- and post-CDSS implementation were minimal. High fever was observed in 57.5% (77/134) cases pre-CDSS and 45.8% (49/107) cases post-CDSS (P = 0.07). Supplemental oxygen was used in 30.6% pre-CDSS and 54.2% post-CDSS cases (P < 0.001). Narrow-spectrum penicillins were prescribed most often, with no statistically significant change post-CDSS implementation (81.3% pre-CDSS, 77.6% post-CDSS, P = 0.47). Macrolides were used consistently throughout the study period (53.7% pre-CDSS, 61.7% post-CDSS; P = 0.21). Conclusion: CDSS implementation did not reduce already low rates of broad-spectrum antibiotic use for uncomplicated CAP.	en_US
dc.relation.ispartof	Journal of Paediatrics and Child Health	en_US
dc.relation.isbasedon	10.1111/jpc.14191	en_US
dc.subject.classification	Pediatrics	en_US
dc.title	Impact of clinical decision support on empirical antibiotic prescribing for children with community-acquired pneumonia	en_US
dc.type	Journal Article
utslib.citation.volume	3	en_US
utslib.citation.volume	55	en_US
utslib.for	1114 Paediatrics and Reproductive Medicine	en_US
utslib.for	1103 Clinical Sciences	en_US
utslib.for	1117 Public Health and Health Services	en_US
pubs.embargo.period	Not known	en_US
pubs.organisational-group	/University of Technology Sydney
pubs.organisational-group	/University of Technology Sydney/Graduate School of Health
pubs.organisational-group	/University of Technology Sydney/Students
utslib.copyright.status	closed_access
pubs.issue	3	en_US
pubs.publication-status	Published	en_US
pubs.volume	55	en_US

Abstract:

© 2018 Paediatrics and Child Health Division (The Royal Australasian College of Physicians) Aim: To assess the impact of a computerised clinical decision support system (CDSS) on antibiotic use in hospitalised children with a presumptive diagnosis of uncomplicated community-acquired pneumonia (CAP). Methods: Codes associated with lower respiratory tract infection were used to identify cases of presumed uncomplicated CAP requiring admission to a tertiary paediatric hospital. Random sampling of the periods between 1 October 2010 and 30 September 2012 (pre-CDSS) and 1 October 2012 and 30 September 2014 (post-CDSS) determined the sequence of case assessment by two independent investigators. Initial antibiotic therapy, associated CDSS approvals and documented signs of clinical deterioration prior to antibiotic decision-making were recorded. Results: Statistically significant differences between cases pre- and post-CDSS implementation were minimal. High fever was observed in 57.5% (77/134) cases pre-CDSS and 45.8% (49/107) cases post-CDSS (P = 0.07). Supplemental oxygen was used in 30.6% pre-CDSS and 54.2% post-CDSS cases (P < 0.001). Narrow-spectrum penicillins were prescribed most often, with no statistically significant change post-CDSS implementation (81.3% pre-CDSS, 77.6% post-CDSS, P = 0.47). Macrolides were used consistently throughout the study period (53.7% pre-CDSS, 61.7% post-CDSS; P = 0.21). Conclusion: CDSS implementation did not reduce already low rates of broad-spectrum antibiotic use for uncomplicated CAP.

Please use this identifier to cite or link to this item:

http://hdl.handle.net/10453/135447