{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,10]],"date-time":"2026-10-10T17:40:03Z","timestamp":1791654003303,"version":"4.3.4"},"reference-count":34,"publisher":"Cambridge University Press (CUP)","issue":"2","license":[{"start":{"date-parts":[[2024,12,3]],"date-time":"2024-12-03T00:00:00Z","timestamp":1733184000000},"content-version":"unspecified","delay-in-days":0,"URL":"https:\/\/www.cambridge.org\/core\/terms"}],"content-domain":{"domain":["cambridge.org"],"crossmark-restriction":true},"short-container-title":["Infect. Control Hosp. Epidemiol."],"published-print":{"date-parts":[[2025,2]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec id=\"S0899823X2400196X_as1\"><jats:title>Objective:<\/jats:title><jats:p>To determine whether differences exist in antibiotic prescribing for respiratory infections in pediatric urgent cares (PUCs) by patient race\/ethnicity, insurance, and language.<\/jats:p><\/jats:sec><jats:sec id=\"S0899823X2400196X_as2\"><jats:title>Design:<\/jats:title><jats:p>Multi-center cohort study.<\/jats:p><\/jats:sec><jats:sec id=\"S0899823X2400196X_as3\"><jats:title>Setting:<\/jats:title><jats:p>Nine organizations (92 locations) from 22 states and Washington, DC.<\/jats:p><\/jats:sec><jats:sec id=\"S0899823X2400196X_as4\"><jats:title>Participants:<\/jats:title><jats:p>Patients ages 6 months\u201318 years evaluated April 2022\u2013April 2023, with acute viral respiratory infections, otitis media with effusion (OME), acute otitis media (AOM), pharyngitis, community-acquired pneumonia (CAP), and sinusitis.<\/jats:p><\/jats:sec><jats:sec id=\"S0899823X2400196X_as5\"><jats:title>Methods:<\/jats:title><jats:p>We compared the use of first-line (FL) therapy as defined by published guidelines. We used race\/ethnicity, insurance, and language as exposures. Multivariable logistic regression models estimated the odds of FL therapy by group.<\/jats:p><\/jats:sec><jats:sec id=\"S0899823X2400196X_as6\"><jats:title>Results:<\/jats:title><jats:p>We evaluated 396,340 ARI encounters. Among all encounters, 351,930 (88.8%) received FL therapy (98% for viral respiratory infections, 85.4% for AOM, 96.0% for streptococcal pharyngitis, 83.6% for sinusitis). OME and CAP had the lowest rates of FL therapy (49.9% and 60.7%, respectively). Adjusted odds of receiving FL therapy were higher in Black Non-Hispanic (NH) (adjusted odds ratio [aOR] 1.53 [1.47, 1.59]), Asian NH (aOR 1.46 [1.40, 1.53], and Hispanic children (aOR 1.37 [1.33, 1.41]), compared to White NH. Additionally, odds of receiving FL therapy were higher in children with Medicaid\/Medicare (aOR 1.21 [1.18\u20131.24]) and self-pay (aOR 1.18 [1.1\u20131.27]) compared to those with commercial insurance.<\/jats:p><\/jats:sec><jats:sec id=\"S0899823X2400196X_as7\"><jats:title>Conclusions:<\/jats:title><jats:p>This multicenter collaborative showed lower rates of FL therapy for children of the White NH race and those with commercial insurance compared to other groups. Exploring these differences through a health equity lens is important for developing mitigating strategies.<\/jats:p><\/jats:sec>","DOI":"10.1017\/ice.2024.196","type":"journal-article","created":{"date-parts":[[2024,12,3]],"date-time":"2024-12-03T05:11:07Z","timestamp":1733202667000},"page":"171-179","update-policy":"https:\/\/doi.org\/10.1017\/policypage","source":"Crossref","is-referenced-by-count":2,"title":["Sociodemographic differences in treatment of acute respiratory infections in pediatric urgent cares"],"prefix":"10.1017","volume":"46","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-7533-1144","authenticated-orcid":false,"given":"Rana E.","family":"El Feghaly","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Luis E.","family":"Sainz","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-1337-1105","authenticated-orcid":false,"given":"Brian R.","family":"Lee","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-1856-6841","authenticated-orcid":false,"given":"Matthew P.","family":"Kronman","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-0148-046X","authenticated-orcid":false,"given":"Adam L.","family":"Hersh","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-0112-537X","authenticated-orcid":false,"given":"Victoria","family":"Parente","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-4003-039X","authenticated-orcid":false,"given":"Destani","family":"Bizune","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Guillermo V.","family":"Sanchez","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-7536-3020","authenticated-orcid":false,"given":"Rana F.","family":"Hamdy","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-5564-3762","authenticated-orcid":false,"given":"Amanda","family":"Nedved","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"name":"For REDUCE (Reducing Differences in Urgent Care Encounters \u2013 Antibiotic Choice) Collaborative","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"56","published-online":{"date-parts":[[2024,12,3]]},"reference":[{"key":"S0899823X2400196X_ref10","doi-asserted-by":"publisher","DOI":"10.1542\/peds.2012-2500"},{"key":"S0899823X2400196X_ref11","doi-asserted-by":"publisher","DOI":"10.1017\/ice.2023.107"},{"key":"S0899823X2400196X_ref18","doi-asserted-by":"publisher","DOI":"10.1017\/ash.2021.230"},{"key":"S0899823X2400196X_ref1","unstructured":"1. Centers for disease control and prevention. Antibiotic resistance threats in the United States 2019. 2019. https:\/\/www.cdc.gov\/drugresistance\/pdf\/threats-report\/2019-ar-threats-report-508.pdf. Accessed July 07, 2021."},{"key":"S0899823X2400196X_ref29","doi-asserted-by":"publisher","DOI":"10.1001\/jama.2021.25181"},{"key":"S0899823X2400196X_ref4","doi-asserted-by":"publisher","DOI":"10.1093\/cid\/ciaa667"},{"key":"S0899823X2400196X_ref14","doi-asserted-by":"publisher","DOI":"10.1016\/j.ajic.2022.07.027"},{"key":"S0899823X2400196X_ref17","doi-asserted-by":"publisher","DOI":"10.1001\/jama.2016.4151"},{"key":"S0899823X2400196X_ref22","unstructured":"22. United States Census Bureau. What Updates to OMB\u2019s Race\/Ethnicity Standards Mean for the Census Bureau. 2024. https:\/\/www.census.gov\/newsroom\/blogs\/random-samplings\/2024\/04\/updates-race-ethnicity-standards.html. Accessed August 08, 2024."},{"key":"S0899823X2400196X_ref24","doi-asserted-by":"publisher","DOI":"10.1542\/hpeds.2021-006462"},{"key":"S0899823X2400196X_ref15","doi-asserted-by":"publisher","DOI":"10.1017\/ice.2023.258"},{"key":"S0899823X2400196X_ref20","doi-asserted-by":"publisher","DOI":"10.1016\/j.ajic.2020.08.023"},{"key":"S0899823X2400196X_ref28","doi-asserted-by":"publisher","DOI":"10.1001\/jamapediatrics.2015.1915"},{"key":"S0899823X2400196X_ref19","first-page":"990","volume-title":"Red Book 2021-2024 Report of the Committee on Infectious Diseases","author":"Kimberlin","year":"2021"},{"key":"S0899823X2400196X_ref5","doi-asserted-by":"publisher","DOI":"10.1542\/peds.2012-3488"},{"key":"S0899823X2400196X_ref13","doi-asserted-by":"publisher","DOI":"10.1093\/ofid\/ofad440"},{"key":"S0899823X2400196X_ref6","doi-asserted-by":"publisher","DOI":"10.1093\/cid\/cis847"},{"key":"S0899823X2400196X_ref16","doi-asserted-by":"publisher","DOI":"10.1136\/bmj.39335.541782.AD"},{"key":"S0899823X2400196X_ref21","doi-asserted-by":"publisher","DOI":"10.1016\/j.jbi.2008.08.010"},{"key":"S0899823X2400196X_ref8","doi-asserted-by":"publisher","DOI":"10.1542\/peds.2013-1071"},{"key":"S0899823X2400196X_ref27","doi-asserted-by":"publisher","DOI":"10.1111\/acem.14274"},{"key":"S0899823X2400196X_ref32","doi-asserted-by":"publisher","DOI":"10.1016\/j.ajic.2023.12.014"},{"key":"S0899823X2400196X_ref23","doi-asserted-by":"publisher","DOI":"10.1542\/peds.2018-1056"},{"key":"S0899823X2400196X_ref3","doi-asserted-by":"publisher","DOI":"10.1001\/jamainternmed.2018.1632"},{"key":"S0899823X2400196X_ref12","doi-asserted-by":"publisher","DOI":"10.1016\/j.jpeds.2023.113572"},{"key":"S0899823X2400196X_ref31","doi-asserted-by":"publisher","DOI":"10.1377\/hlthaff.2022.00482"},{"key":"S0899823X2400196X_ref33","doi-asserted-by":"publisher","DOI":"10.1016\/j.sapharm.2022.10.010"},{"key":"S0899823X2400196X_ref34","doi-asserted-by":"publisher","DOI":"10.1186\/s12875-019-0980-1"},{"key":"S0899823X2400196X_ref30","doi-asserted-by":"publisher","DOI":"10.1111\/pai.14126"},{"key":"S0899823X2400196X_ref26","doi-asserted-by":"publisher","DOI":"10.1001\/jamapediatrics.2023.4890"},{"key":"S0899823X2400196X_ref25","doi-asserted-by":"publisher","DOI":"10.1001\/jamanetworkopen.2022.2117"},{"key":"S0899823X2400196X_ref7","doi-asserted-by":"publisher","DOI":"10.1093\/cid\/cir531"},{"key":"S0899823X2400196X_ref2","doi-asserted-by":"publisher","DOI":"10.1542\/peds.2020-040295"},{"key":"S0899823X2400196X_ref9","first-page":"140","article-title":"Racial and ethnic differences in antibiotic use for viral illness in emergency departments","author":"Goyal","year":"2017","journal-title":"Pediatrics"}],"container-title":["Infection Control &amp; Hospital Epidemiology"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.cambridge.org\/core\/services\/aop-cambridge-core\/content\/view\/S0899823X2400196X","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,2,11]],"date-time":"2025-02-11T00:26:44Z","timestamp":1739233604000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.cambridge.org\/core\/product\/identifier\/S0899823X2400196X\/type\/journal_article"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2024,12,3]]},"references-count":34,"journal-issue":{"issue":"2","published-print":{"date-parts":[[2025,2]]}},"alternative-id":["S0899823X2400196X"],"URL":"https:\/\/doi.org\/10.1017\/ice.2024.196","relation":{},"ISSN":["0899-823X","1559-6834"],"issn-type":[{"value":"0899-823X","type":"print"},{"value":"1559-6834","type":"electronic"}],"subject":[],"published":{"date-parts":[[2024,12,3]]},"assertion":[{"value":"\u00a9 The Author(s), 2024. Published by Cambridge University Press on behalf of The Society for Healthcare Epidemiology of America","name":"copyright","label":"Copyright","group":{"name":"copyright_and_licensing","label":"Copyright and Licensing"}}]}}