{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,9]],"date-time":"2026-10-09T04:50:58Z","timestamp":1791521458769,"version":"4.3.4"},"reference-count":29,"publisher":"Cambridge University Press (CUP)","license":[{"start":{"date-parts":[[2026,10,9]],"date-time":"2026-10-09T00:00:00Z","timestamp":1791504000000},"content-version":"unspecified","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["cambridge.org"],"crossmark-restriction":true},"short-container-title":["Infect. Control Hosp. Epidemiol."],"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec id=\"S0899823X26105674_as1\">\n                    <jats:title>Objective:<\/jats:title>\n                    <jats:p>To evaluate the association between department-level implementation of broad multiplex respiratory pathogen panels and antibacterial prescribing.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec id=\"S0899823X26105674_as2\">\n                    <jats:title>Design:<\/jats:title>\n                    <jats:p>Retrospective repeated cross-sectional staggered-adoption study with cohort-stacked difference-in-differences models.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec id=\"S0899823X26105674_as3\">\n                    <jats:title>Setting:<\/jats:title>\n                    <jats:p>US emergency and urgent-care departments contributing deidentified electronic health record data to Epic Cosmos, 2016\u20132025.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec id=\"S0899823X26105674_as4\">\n                    <jats:title>Participants:<\/jats:title>\n                    <jats:p>Adults with acute respiratory illness without a concurrent clear nonrespiratory bacterial indication.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec id=\"S0899823X26105674_as5\">\n                    <jats:title>Methods:<\/jats:title>\n                    <jats:p>Incident implementation was the first sustained increase in strict panel use from below 2% to at least 10%, with complete 8-quarter preimplementation and postimplementation windows. Adopters were compared with contemporaneous nonadopters and not-yet-adopters. The primary outcome was a same-day systemic oral or enteral antibacterial order after emergency department discharge.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec id=\"S0899823X26105674_as6\">\n                    <jats:title>Results:<\/jats:title>\n                    <jats:p>\n                      Among 55,059,432 eligible encounters, 32 adopting departments in 9 cohorts were compared with 1,075 departments, yielding 114,832 department-quarter observations. Implementation was associated with a 23.53-percentage-point increase in panel use (95% CI, 20.32 to 26.74) and a 1.21-percentage-point reduction in same-day antibacterial prescribing (95% CI, \u22122.37 to \u22120.05;\n                      <jats:italic>P<\/jats:italic>\n                      = .041), a 5.7% relative decrease. However, alternative 5, 15, and 20% thresholds were not statistically significant, unrestricted analyses were null, and several preimplementation diagnostics rejected flat trends.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec id=\"S0899823X26105674_as7\">\n                    <jats:title>Conclusions:<\/jats:title>\n                    <jats:p>Sustained panel implementation was associated with a small reduction in antibiotic prescribing. Threshold sensitivity and mixed preimplementation diagnostics limit causal interpretation and support integrating testing into broader diagnostic-stewardship workflows.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1017\/ice.2026.10567","type":"journal-article","created":{"date-parts":[[2026,10,9]],"date-time":"2026-10-09T04:35:20Z","timestamp":1791520520000},"page":"1-8","update-policy":"https:\/\/doi.org\/10.1017\/policypage","source":"Crossref","is-referenced-by-count":0,"title":["Broad multiplex respiratory panel implementation and antibiotic prescribing in US emergency and urgent care departments: a staggered-adoption study"],"prefix":"10.1017","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-0333-1070","authenticated-orcid":false,"given":"Mayar","family":"Al Mohajer","sequence":"first","affiliation":[{"id":[{"id":"https:\/\/ror.org\/02pttbw34","id-type":"ROR","asserted-by":"publisher"}],"name":"Section of Infectious Diseases, Department of Medicine, Baylor College of 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M.","family":"Lasco","sequence":"additional","affiliation":[{"name":"Department of Pathology & Immunology, Baylor College of Medicine"},{"name":"Baylor St. Luke\u2019s Medical Center"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"56","published-online":{"date-parts":[[2026,10,9]]},"reference":[{"key":"S0899823X26105674_ref16","doi-asserted-by":"publisher","DOI":"10.1146\/annurev-publhealth-061022-050825"},{"key":"S0899823X26105674_ref10","doi-asserted-by":"publisher","DOI":"10.1371\/journal.pmed.1001885"},{"key":"S0899823X26105674_ref8","doi-asserted-by":"crossref","first-page":"e36","DOI":"10.1055\/s-0041-1731004","article-title":"The Cosmos Collaborative: a vendor-facilitated electronic health record data aggregation platform","volume":"5","author":"Tarabichi","year":"2021","journal-title":"ACI Open"},{"key":"S0899823X26105674_ref27","doi-asserted-by":"publisher","DOI":"10.1128\/spectrum.02195-25"},{"key":"S0899823X26105674_ref13","article-title":"A social 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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 licence (https:\/\/creativecommons.org\/licenses\/by\/4.0\/), which permits unrestricted re-use, distribution and reproduction, provided the original article is properly cited.","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"}]}}