{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,1]],"date-time":"2026-09-01T22:58:58Z","timestamp":1788303538899,"version":"build-2803163510"},"reference-count":26,"publisher":"Cambridge University Press (CUP)","issue":"6","license":[{"start":{"date-parts":[[2025,4,8]],"date-time":"2025-04-08T00:00:00Z","timestamp":1744070400000},"content-version":"unspecified","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc-sa\/4.0\/"}],"content-domain":{"domain":["cambridge.org"],"crossmark-restriction":true},"short-container-title":["Infect. Control Hosp. Epidemiol."],"published-print":{"date-parts":[[2025,6]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec id=\"S0899823X25000595_as1\">\n                    <jats:title>Objective:<\/jats:title>\n                    <jats:p>Antibiotic stewardship programs (ASPs) target hospitalized children, but most do not routinely review antibiotic prescriptions at discharge, despite 30% of discharged children receiving additional antibiotics. Our objective is to describe discharge antibiotic prescribing in children hospitalized for uncomplicated community-acquired pneumonia (CAP), skin\/soft tissue infection (SSTI), and urinary tract infection (UTI).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec id=\"S0899823X25000595_as2\">\n                    <jats:title>Design:<\/jats:title>\n                    <jats:p>Retrospective cohort study.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec id=\"S0899823X25000595_as3\">\n                    <jats:title>Setting:<\/jats:title>\n                    <jats:p>Four academic children\u2019s hospitals with established ASPs.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec id=\"S0899823X25000595_as4\">\n                    <jats:title>Patients:<\/jats:title>\n                    <jats:p>ICD-10 codes identified 3,847 encounters for children &lt;18 years admitted from January 1, 2021 to December 31, 2021 and prescribed antibiotics at discharge for uncomplicated CAP, SSTI, or UTI. After excluding children with medical complexity and encounters with concomitant infections, &gt;7 days hospital stay, or intensive care unit stay, 1,206 encounters were included.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec id=\"S0899823X25000595_as5\">\n                    <jats:title>Methods:<\/jats:title>\n                    <jats:p>Primary outcomes were the percentage of subjects prescribed optimal (1) total (inpatient plus outpatient) duration of therapy (DOT) and (2) antibiotic choice based on current national guidelines and available evidence.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec id=\"S0899823X25000595_as6\">\n                    <jats:title>Results:<\/jats:title>\n                    <jats:p>Of 226 encounters for CAP, 417 for UTI, and 563 for SSTI, the median age was 4 years, 52% were female, and the median DOT was 9\u00a0days (8 for CAP, 10 for UTI, and 9 for SSTI). Antibiotic choice was optimal for 77%, and DOT was optimal for 26%. Only 20% of antibiotic courses included both optimal DOT and antibiotic choice.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec id=\"S0899823X25000595_as7\">\n                    <jats:title>Conclusions:<\/jats:title>\n                    <jats:p>At 4 children\u2019s hospitals with established ASPs, 80% of discharge antibiotic courses for CAP, UTI, and SSTI were suboptimal either by choice of antibiotic or DOT. Discharge antibiotic prescribing represents an opportunity to improve antibiotic use in children.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1017\/ice.2025.59","type":"journal-article","created":{"date-parts":[[2025,4,8]],"date-time":"2025-04-08T04:56:37Z","timestamp":1744088197000},"page":"623-628","update-policy":"https:\/\/doi.org\/10.1017\/policypage","source":"Crossref","is-referenced-by-count":2,"title":["Discharge antibiotic prescribing at children\u2019s hospitals with established antimicrobial stewardship programs"],"prefix":"10.1017","volume":"46","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-0337-1168","authenticated-orcid":false,"given":"Rebecca G.","family":"Same","sequence":"first","affiliation":[{"name":"Perelman School of Medicine at the University of Pennsylvania"},{"name":"Children\u2019s Hospital of Philadelphia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Giyoung","family":"Lee","sequence":"additional","affiliation":[{"name":"Children\u2019s Hospital of Philadelphia"},{"name":"Drexel University Dornsife School of Public Health"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jared","family":"Olson","sequence":"additional","affiliation":[{"name":"Primary Children\u2019s Hospital"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Brendan","family":"Bettinger","sequence":"additional","affiliation":[{"name":"Seattle Children\u2019s Hospital"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Adam L.","family":"Hersh","sequence":"additional","affiliation":[{"name":"University of Utah"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-1856-6841","authenticated-orcid":false,"given":"Matthew P.","family":"Kronman","sequence":"additional","affiliation":[{"name":"Seattle Children\u2019s Hospital"},{"name":"University of Washington"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-9979-7993","authenticated-orcid":false,"given":"Jason G.","family":"Newland","sequence":"additional","affiliation":[{"name":"Nationwide Children\u2019s Hospital"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0005-2737-1543","authenticated-orcid":false,"given":"Meg","family":"Grimshaw","sequence":"additional","affiliation":[{"name":"Spencer Fox Eccles School of Medicine"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-3076-3186","authenticated-orcid":false,"given":"Jeffrey S.","family":"Gerber","sequence":"additional","affiliation":[{"name":"Perelman School of Medicine at the University of Pennsylvania"},{"name":"Children\u2019s Hospital of 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2025. 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"}},{"value":"This is an Open Access article, distributed under the terms of the Creative Commons Attribution-NonCommercial-ShareAlike licence (http:\/\/creativecommons.org\/licenses\/by-nc-sa\/4.0\/), which permits non-commercial re-use, distribution, and reproduction in any medium, provided the same Creative Commons licence is used to distribute the re-used or adapted article and the original article is properly cited. The written permission of Cambridge University Press must be obtained prior to any commercial use.","name":"license","label":"License","group":{"name":"copyright_and_licensing","label":"Copyright and Licensing"}},{"value":"This content has been made available to all.","name":"free","label":"Free to read"}]}}