{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,6]],"date-time":"2026-10-06T17:51:38Z","timestamp":1791309098411,"version":"4.3.1"},"reference-count":0,"publisher":"Oxford University Press (OUP)","license":[{"start":{"date-parts":[[2026,10,6]],"date-time":"2026-10-06T00:00:00Z","timestamp":1791244800000},"content-version":"am","delay-in-days":0,"URL":"https:\/\/academic.oup.com\/pages\/standard-publication-reuse-rights"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>Updated guidance for common acute respiratory infections (ARIs) recommends shorter antibiotic durations. While stewardship efforts often focus on appropriate antibiotic selection, it remains unclear whether initiatives targeting first-line choice also influence duration.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Design\/Methods<\/jats:title>\n                    <jats:p>We conducted a secondary analysis of a national quality improvement collaborative including 92 pediatric urgent care sites across 9 organizations in 22 states and Washington, D.C. (April 2022\u2013September 2024). The collaborative emphasized equitable first-line antibiotic selection; duration was not an explicit target. We included encounters for patients aged 6\u00a0months\u201318\u00a0years with ARI International Classification of Diseases-10 (ICD-10) diagnoses resulting in an antibiotic prescription and excluded azithromycin. October 2023\u2013April 2024 was defined as the intervention period during active Plan-Do-Study-Act cycles. The primary outcome was short-course prescribing (\u22647\u00a0days). Multivariable, multilevel logistic regression models estimated odds of \u22647-day duration across time periods (pre-collaborative, intervention, post-collaborative) and sociodemographic groups.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>Among 257\u2009879 encounters, acute otitis media was most common (160\u2009292; 62.2%). We saw an increase in \u22647-day duration prescribing from 33.4% pre-collaborative to 35.9% during the intervention and 37.8% post-collaborative. This increase was most notable for sinusitis (11.2% pre-collaborative to 33.9% post-collaborative). Compared with the pre-collaborative period, odds of \u22647-day duration were higher during intervention (aOR 1.22, 95% CI 1.18, 1.25, p\u2009&amp;lt;\u20090.001) and post-collaborative periods (aOR 1.31, 95% CI 1.27, 1.35, p\u2009&amp;lt;\u20090.001). Differences in duration were observed by race, language, and payor type.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>During a collaborative focused on equitable first-line antibiotic selection, short-course prescribing increased, suggesting potential spillover to duration alongside broader secular trends. Persistent sociodemographic differences highlight the need to explicitly incorporate equity into outpatient stewardship efforts beyond antibiotic choice.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1093\/jpids\/piag099","type":"journal-article","created":{"date-parts":[[2026,9,20]],"date-time":"2026-09-20T11:21:40Z","timestamp":1789903300000},"source":"Crossref","is-referenced-by-count":0,"title":["Impact of a Multi-Center Collaborative on Antibiotic Duration for Acute Respiratory Infections in Pediatric Urgent Care"],"prefix":"10.1093","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-5564-3762","authenticated-orcid":false,"given":"Amanda","family":"Nedved","sequence":"first","affiliation":[{"name":"Department of Pediatrics, Children\u2019s Mercy , Kansas City, MO ,","place":["United States"]},{"name":"Department of Pediatrics, University of Missouri-Kansas City , Kansas City, MO ,","place":["United States"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Brian","family":"Lee","sequence":"additional","affiliation":[{"name":"Department of Pediatrics, Children\u2019s Mercy , Kansas City, MO ,","place":["United States"]},{"name":"Department of Pediatrics, University of Missouri-Kansas City , Kansas City, MO ,","place":["United States"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Luis E","family":"Sainz","sequence":"additional","affiliation":[{"name":"Department of Pediatrics, Children\u2019s Mercy , Kansas City, MO ,","place":["United States"]}],"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":"Department of Pediatrics, University of Washington School of Medicine , Seattle Children\u2019s Hospital, Seattle, WA ,","place":["United States"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Adam L","family":"Hersh","sequence":"additional","affiliation":[{"name":"Division of Infectious Diseases, Department of Pediatrics, University of Utah , Salt Lake City, UT ,","place":["United States"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Victoria","family":"Parente","sequence":"additional","affiliation":[{"name":"Department of Pediatrics, Duke University School of Medicine , Durham, NC ,","place":["United States"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-7536-3020","authenticated-orcid":false,"given":"Rana F","family":"Hamdy","sequence":"additional","affiliation":[{"name":"Division of Infectious Diseases, Children\u2019s National Hospital , Washington, DC ,","place":["United States"]},{"name":"Department of Pediatrics, George Washington University School of Medicine and Health Sciences , Washington, DC ,","place":["United States"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-7533-1144","authenticated-orcid":false,"given":"Rana E","family":"El Feghaly","sequence":"additional","affiliation":[{"name":"Department of Pediatrics, Children\u2019s Mercy , Kansas City, MO ,","place":["United States"]},{"name":"Department of Pediatrics, University of Missouri-Kansas City , Kansas City, MO ,","place":["United States"]}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"286","published-online":{"date-parts":[[2026,10,6]]},"container-title":["Journal of the Pediatric Infectious Diseases Society"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/academic.oup.com\/jpids\/advance-article-pdf\/doi\/10.1093\/jpids\/piag099\/71628567\/piag099.pdf","content-type":"application\/pdf","content-version":"am","intended-application":"syndication"},{"URL":"https:\/\/academic.oup.com\/jpids\/advance-article-pdf\/doi\/10.1093\/jpids\/piag099\/71628567\/piag099.pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,10,6]],"date-time":"2026-10-06T17:05:53Z","timestamp":1791306353000},"score":1,"resource":{"primary":{"URL":"https:\/\/academic.oup.com\/jpids\/advance-article\/doi\/10.1093\/jpids\/piag099\/8869141"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,10,6]]},"references-count":0,"URL":"https:\/\/doi.org\/10.1093\/jpids\/piag099","relation":{},"ISSN":["2048-7207"],"issn-type":[{"value":"2048-7207","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,10,6]]},"article-number":"piag099"}}