{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,3,7]],"date-time":"2026-03-07T22:58:26Z","timestamp":1772924306997,"version":"3.50.1"},"reference-count":23,"publisher":"Wiley","issue":"3","license":[{"start":{"date-parts":[[2018,8,30]],"date-time":"2018-08-30T00:00:00Z","timestamp":1535587200000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["J Paediatrics Child Health"],"published-print":{"date-parts":[[2019,3]]},"abstract":"<jats:sec><jats:title>Aim<\/jats:title><jats:p>To assess the impact of a computerised clinical decision support system (CDSS) on antibiotic use in hospitalised children with a presumptive diagnosis of uncomplicated community\u2010acquired pneumonia (CAP).<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>Codes associated with lower respiratory tract infection were used to identify cases of presumed uncomplicated CAP requiring admission to a tertiary paediatric hospital. Random sampling of the periods between 1 October 2010 and 30 September 2012 (pre\u2010CDSS) and 1 October 2012 and 30 September 2014 (post\u2010CDSS) determined the sequence of case assessment by two independent investigators. Initial antibiotic therapy, associated CDSS approvals and documented signs of clinical deterioration prior to antibiotic decision\u2010making were recorded.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>Statistically significant differences between cases pre\u2010 and post\u2010CDSS implementation were minimal. High fever was observed in 57.5% (77\/134) cases pre\u2010CDSS and 45.8% (49\/107) cases post\u2010CDSS (<jats:italic>P<\/jats:italic>\u2009=\u20090.07). Supplemental oxygen was used in 30.6% pre\u2010CDSS and 54.2% post\u2010CDSS cases (<jats:italic>P<\/jats:italic>\u2009&lt;\u20090.001). Narrow\u2010spectrum penicillins were prescribed most often, with no statistically significant change post\u2010CDSS implementation (81.3% pre\u2010CDSS, 77.6% post\u2010CDSS, <jats:italic>P<\/jats:italic>\u2009=\u20090.47). Macrolides were used consistently throughout the study period (53.7% pre\u2010CDSS, 61.7% post\u2010CDSS; <jats:italic>P<\/jats:italic>\u2009=\u20090.21).<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p>CDSS implementation did not reduce already low rates of broad\u2010spectrum antibiotic use for uncomplicated CAP.<\/jats:p><\/jats:sec>","DOI":"10.1111\/jpc.14191","type":"journal-article","created":{"date-parts":[[2018,8,30]],"date-time":"2018-08-30T20:23:53Z","timestamp":1535660633000},"page":"305-311","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":10,"title":["Impact of clinical decision support on empirical antibiotic prescribing for children with community\u2010acquired pneumonia"],"prefix":"10.1111","volume":"55","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-9918-7765","authenticated-orcid":false,"given":"Mona","family":"Mostaghim","sequence":"first","affiliation":[{"name":"Graduate School of Health University of Technology Sydney  Sydney New South Wales Australia"},{"name":"Pharmacy Department Sydney Children's Hospital  Sydney New South Wales Australia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Tom","family":"Snelling","sequence":"additional","affiliation":[{"name":"Department of Infectious Diseases Princess Margaret Hospital for Children  Perth Western Australia Australia"},{"name":"Wesfarmers Centre of Vaccines and Infectious Diseases, Telethon Kids Institute University of Western Australia  Perth Western Australia Australia"},{"name":"Menzies School of Health Research Charles Darwin University  Darwin Northern Territory Australia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Brendan","family":"McMullan","sequence":"additional","affiliation":[{"name":"Department of Immunology and Infectious Diseases Sydney Children's Hospital  Sydney New South Wales Australia"},{"name":"School of Women's and Children's Health University of New South Wales  Sydney New South Wales Australia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Yean H","family":"Ewe","sequence":"additional","affiliation":[{"name":"Junior Medical Unit Sydney Children's Hospital  Sydney New South Wales Australia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Beata","family":"Bajorek","sequence":"additional","affiliation":[{"name":"Graduate School of Health University of Technology Sydney  Sydney New South Wales Australia"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"311","published-online":{"date-parts":[[2018,8,30]]},"reference":[{"key":"e_1_2_8_2_1","doi-asserted-by":"publisher","DOI":"10.1007\/s11908-016-0521-1"},{"key":"e_1_2_8_3_1","doi-asserted-by":"publisher","DOI":"10.1093\/cid\/cir625"},{"key":"e_1_2_8_4_1","doi-asserted-by":"publisher","DOI":"10.1542\/peds.2013-1614"},{"key":"e_1_2_8_5_1","doi-asserted-by":"publisher","DOI":"10.1093\/cid\/ciu013"},{"key":"e_1_2_8_6_1","doi-asserted-by":"publisher","DOI":"10.1128\/CMR.18.4.638-656.2005"},{"key":"e_1_2_8_7_1","doi-asserted-by":"publisher","DOI":"10.1086\/673982"},{"key":"e_1_2_8_8_1","unstructured":"Clinical Excellence Commission.Paediatric Quality Program: Between the Flags.Sydney: The Commission; 2017. 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