{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,1,28]],"date-time":"2026-01-28T10:50:00Z","timestamp":1769597400682,"version":"3.49.0"},"reference-count":29,"publisher":"Oxford University Press (OUP)","issue":"6","license":[{"start":{"date-parts":[[2025,5,21]],"date-time":"2025-05-21T00:00:00Z","timestamp":1747785600000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/academic.oup.com\/pages\/standard-publication-reuse-rights"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2025,10,4]]},"abstract":"<jats:title>Abstract<\/jats:title>\n               <jats:sec>\n                  <jats:title>Background<\/jats:title>\n                  <jats:p>Recent evidence-based pediatric guidelines recommend a 5-day course of amoxicillin as first-line therapy for uncomplicated acute otitis media (AOM) in children 2 years and older and community-acquired pneumonia (CAP). The objective of this study was to assess the guideline consistency of antibiotic prescriptions for AOM and CAP in a Canadian quaternary care pediatric emergency department (ED) and identify opportunities to improve antibiotic prescribing.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Methods<\/jats:title>\n                  <jats:p>We retrospectively reviewed antibiotic prescriptions for patients 0 to 18 years old discharged from the ED with a diagnosis of AOM or CAP from September 2022 through September 2023. Clinical information and prescription data were extracted from the electronic medical record. Analysis was completed using descriptive statistics.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Results<\/jats:title>\n                  <jats:p>Of 2313 retrieved records, 1143 (85%) cases of AOM and 753 (75%) cases of CAP met the inclusion criteria. Six hundred and eighty-eight (60%) AOM prescriptions and 140 (19%) CAP prescriptions were guideline-consistent. Prescriptions were not guideline-consistent largely because of antibiotic duration (62% for AOM\u201467% attributable to excess duration; 93% for CAP\u2014\u2005&amp;gt;\u200599% attributable to excess duration), followed by antibiotic dosing interval (31% for AOM; 22% for CAP), antibiotic selection (17% for AOM; 6% for CAP) and antibiotic dose (8% for AOM; 2% for CAP). Of 293 patients eligible for deferred prescriptions for AOM based on age and clinical presentation, only 52% received them.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Conclusions<\/jats:title>\n                  <jats:p>Most guideline-discordant prescriptions for both AOM and CAP resulted from prolonged antibiotic duration. Given the frequency of these diagnoses, effective interventions to improve guideline consistency would have a significant impact at a population level.<\/jats:p>\n               <\/jats:sec>","DOI":"10.1093\/pch\/pxaf036","type":"journal-article","created":{"date-parts":[[2025,5,21]],"date-time":"2025-05-21T13:04:20Z","timestamp":1747832660000},"page":"486-492","source":"Crossref","is-referenced-by-count":1,"title":["Antibiotic prescribing practices for acute otitis media and community-acquired pneumonia in a pediatric emergency department"],"prefix":"10.1093","volume":"30","author":[{"ORCID":"https:\/\/orcid.org\/0009-0002-2067-0223","authenticated-orcid":false,"given":"Dara Simcha","family":"Petel","sequence":"first","affiliation":[{"name":"Division of Infectious Diseases, The Hospital for Sick Children , Toronto, Ontario ,","place":["Canada"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Leo","family":"Cheong","sequence":"additional","affiliation":[{"name":"Department of Paediatrics, The Hospital for Sick Children , Toronto, Ontario ,","place":["Canada"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Gregory","family":"Harvey","sequence":"additional","affiliation":[{"name":"Department of Paediatrics, The Hospital for Sick Children , Toronto, Ontario ,","place":["Canada"]},{"name":"Division of Emergency Medicine, The Hospital for Sick Children , Toronto, Ontario ,","place":["Canada"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Olivia","family":"Ostrow","sequence":"additional","affiliation":[{"name":"Department of Paediatrics, The Hospital for Sick Children , Toronto, Ontario ,","place":["Canada"]},{"name":"Division of Emergency Medicine, The Hospital for Sick Children , Toronto, Ontario ,","place":["Canada"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Kathryn","family":"Timberlake","sequence":"additional","affiliation":[{"name":"Department of Pharmacy, The Hospital for Sick Children , Toronto, Ontario ,","place":["Canada"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-2855-8570","authenticated-orcid":false,"given":"Michelle","family":"Science","sequence":"additional","affiliation":[{"name":"Division of Infectious Diseases, The Hospital for Sick Children , Toronto, Ontario ,","place":["Canada"]},{"name":"Department of Paediatrics, The Hospital for Sick Children , Toronto, Ontario ,","place":["Canada"]}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"286","published-online":{"date-parts":[[2025,5,21]]},"reference":[{"issue":"1","key":"2025100407171161100_CIT0001","doi-asserted-by":"publisher","first-page":"e001218","DOI":"10.1136\/bmjresp-2022-001218","article-title":"Estimating 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