{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,17]],"date-time":"2026-08-17T14:52:33Z","timestamp":1786978353919,"version":"build-2736575974"},"reference-count":46,"publisher":"Wiley","issue":"8","license":[{"start":{"date-parts":[[2025,8,8]],"date-time":"2025-08-08T00:00:00Z","timestamp":1754611200000},"content-version":"vor","delay-in-days":7,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"},{"start":{"date-parts":[[2025,8,1]],"date-time":"2025-08-01T00:00:00Z","timestamp":1754006400000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"funder":[{"DOI":"10.13039\/100001130","name":"Gerber Foundation","doi-asserted-by":"publisher","id":[{"id":"10.13039\/100001130","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Pediatric Pulmonology"],"published-print":{"date-parts":[[2025,8]]},"abstract":"<jats:title>ABSTRACT<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Objectives<\/jats:title>\n                    <jats:p>To quantify and characterize systemic antibiotic prescribing among children with tracheostomies, and to identify predictors of higher prescribing.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Study Design<\/jats:title>\n                    <jats:p>This single\u2010center retrospective cohort study included children with tracheostomies 2 months\u201018 years old cared for at a quaternary care pediatric institution between 2010 and 2018. Antibiotics prescribed for &gt;1 day were recorded, classified by spectrum of activity, and stratified by setting and year. Presumptively prophylactic antibiotics were excluded. Child\u2010level antibiotic prescribing was quantified using number of courses and days of therapy (DOT) per child per year. Group\u2010level prescribing was summarized using total courses and DOT per 1000 person\u2010days and analyzed by year over study course. Predictors of child\u2010level prescribing were identified using backward elimination multivariable analyses within a generalized linear model.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>The 548 children with tracheostomies were prescribed a median four antibiotic courses per child per year (IQR: 1.9\u201310.0) for a total median exposure of 33.8 DOT per child per year (IQR: 16.1\u201371.6). The group was prescribed 100.7 DOT per 1000 person\u2010days. Most courses (72.7%) were broad\u2010spectrum, with vancomycin, piperacillin\u2010tazobactam, and ampicillin\u2010sulbactam\/ampicillin\u2010clavulanate being the most frequently prescribed courses. Annual antibiotic prescribing decreased 30%\u201333% between 2010 and 2018. Child ventilator use at baseline was associated with fewer DOT per child per year, while higher complexity and more ICU hospital days were risk factors for higher DOT.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>Children with tracheostomies have high systemic antibiotic use and are predominantly prescribed broad\u2010spectrum antibiotics. Chronic ventilator use was associated with lower prescribing. These data may inform antimicrobial stewardship work.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1002\/ppul.71216","type":"journal-article","created":{"date-parts":[[2025,8,8]],"date-time":"2025-08-08T11:40:13Z","timestamp":1754653213000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":4,"title":["Quantifying Antibiotic Prescribing in Children With Tracheostomies"],"prefix":"10.1002","volume":"60","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-5973-475X","authenticated-orcid":false,"given":"Rebecca","family":"Steuart","sequence":"first","affiliation":[{"name":"Department of Pediatrics Section of Complex Care, Medical College of Wisconsin Milwaukee Wisconsin USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Austin","family":"Slone","sequence":"additional","affiliation":[{"name":"University of Cincinnati College of Medicine Cincinnati Ohio 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