{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,4,29]],"date-time":"2026-04-29T01:32:25Z","timestamp":1777426345110,"version":"3.51.4"},"reference-count":20,"publisher":"SAGE Publications","issue":"5","license":[{"start":{"date-parts":[[2025,1,2]],"date-time":"2025-01-02T00:00:00Z","timestamp":1735776000000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/journals.sagepub.com\/page\/policies\/text-and-data-mining-license"}],"funder":[{"DOI":"10.13039\/100000098","name":"Clinical Center","doi-asserted-by":"publisher","award":["UL1 TR001857"],"award-info":[{"award-number":["UL1 TR001857"]}],"id":[{"id":"10.13039\/100000098","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["journals.sagepub.com"],"crossmark-restriction":true},"short-container-title":["Ann Otol Rhinol Laryngol"],"published-print":{"date-parts":[[2025,5]]},"abstract":"<jats:sec>\n                    <jats:title>Background:<\/jats:title>\n                    <jats:p>Granulation tissue formation and tracheitis are common pediatric tracheostomy complications. Ciprofloxacin\/dexamethasone is frequently prescribed, but the influence of social determinants on this topic is unexplored.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods:<\/jats:title>\n                    <jats:p>This study extends a prior cohort study of pediatric tracheostomy patients at a single academic institution from 2016 to 2020. Social determinants of health, including race, insurance status, and residence characteristics, including Area Deprivation Index (ADI), were evaluated. Logistic regression, Wilcoxon rank-sum, and log-rank tests (\u03b1\u2009=\u2009.05) analyzed relationships between these determinants and prescriptions and post-tracheostomy outcomes.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results:<\/jats:title>\n                    <jats:p>\n                      This cohort included 182 patients; 98\/182 (53.9%) were male, and 140\/182 (76.9%) were White, non-Hispanic. Non-White race was associated with increased odds of receiving nebulized ciprofloxacin\/dexamethasone (OR\u2009=\u20092.80, 95% CI\u2009=\u20091.25-6.29). In those with tracheal culture results available (n\u2009=\u200963), Staphylococcus aureus was more common with public insurance (29\/47, 7 with MRSA, 61.7%) compared with private (5\/16, 3 with MRSA, 31.3%; OR\u2009=\u20093.54, 95% CI\u2009=\u20091.05-11.9). ADI was greater in the 7 patients with Streptococcus pneumoniae (median\u2009=\u200995, IQR\u2009=\u200988-99) compared to without (median\u2009=\u200977, IQR\u2009=\u200965-81,\n                      <jats:italic>P<\/jats:italic>\n                      \u2009=\u2009.003). Patients with tracheitis lived further from our center (median\u2009=\u200944.7\u2009miles, IQR\u2009=\u200927.7-91.4\u2009miles) compared with those who did not develop tracheitis (median\u2009=\u200933.4\u2009miles, IQR\u2009=\u200912.0-85.2\u2009miles,\n                      <jats:italic>P<\/jats:italic>\n                      \u2009=\u2009.02). Antibiotic resistance was more prevalent in children discharged home (14\/35, 40.0%) than to transitional care (3\/28, 10.7%; OR\u2009=\u20095.56, 95% CI\u2009=\u20091.40-22.0) and was associated with longer hospital stays (median\u2009=\u200970\u2009days, range\u2009=\u200934-152 vs median\u2009=\u200935\u2009days, range\u2009=\u200915-75\u2009days,\n                      <jats:italic>P<\/jats:italic>\n                      \u2009=\u2009.02). Non-White patients experience increased odds of decannulation over time compared with White patients (HR\u2009=\u20092.85, 95% CI\u2009=\u20091.21-6.70). Discharge locations and ADI were associated with dressing choice post-tracheostomy.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Discussion:<\/jats:title>\n                    <jats:p>This study revealed racial disparities in ciprofloxacin\/dexamethasone usage, residence-related differences in tracheal culture results, and ADI-related dressing choices, which highlight the need for tailored, equitable care to optimize outcomes.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Level of Evidence:<\/jats:title>\n                    <jats:p>4<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1177\/00034894241310342","type":"journal-article","created":{"date-parts":[[2025,1,2]],"date-time":"2025-01-02T06:28:44Z","timestamp":1735799324000},"page":"341-348","update-policy":"https:\/\/doi.org\/10.1177\/sage-journals-update-policy","source":"Crossref","is-referenced-by-count":1,"title":["Disparities in Medication Prescriptions and Post-Tracheostomy Outcomes in Pediatric Patients"],"prefix":"10.1177","volume":"134","author":[{"ORCID":"https:\/\/orcid.org\/0009-0004-0782-2602","authenticated-orcid":false,"given":"Pooja D.","family":"Reddy","sequence":"first","affiliation":[{"name":"University of Pittsburgh School of Medicine, Pittsburgh, PA, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0009-0000-9996-6670","authenticated-orcid":false,"given":"Akshaya","family":"Raman","sequence":"additional","affiliation":[{"name":"University of Pittsburgh School of Medicine, Pittsburgh, PA, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Soukaina","family":"Eljamri","sequence":"additional","affiliation":[{"name":"University of Pittsburgh School of Medicine, Pittsburgh, PA, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Amber","family":"Shaffer","sequence":"additional","affiliation":[{"name":"UPMC Children\u2019s Hospital of Pittsburgh, Pittsburgh, PA, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-5876-7816","authenticated-orcid":false,"given":"Reema","family":"Padia","sequence":"additional","affiliation":[{"name":"University of Pittsburgh School of Medicine, Pittsburgh, PA, USA"},{"name":"UPMC Children\u2019s Hospital of Pittsburgh, Pittsburgh, PA, USA"},{"name":"University of Utah, Salt Lake City, UT, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"179","published-online":{"date-parts":[[2025,1,2]]},"reference":[{"key":"e_1_3_2_2_2","doi-asserted-by":"publisher","DOI":"10.1002\/lary.26995"},{"key":"e_1_3_2_3_2","doi-asserted-by":"publisher","DOI":"10.1002\/lary.29576"},{"key":"e_1_3_2_4_2","doi-asserted-by":"publisher","DOI":"10.1177\/0194599820988501"},{"key":"e_1_3_2_5_2","volume-title":"Post-operative Challenges in Pediatric Tracheostomy: Exploring Granulation Tissue Formation, Complications, and the Potential Role of Ciprofloxacin\/Dexamethasone","author":"Reddy PD","year":"2023","unstructured":"Reddy PD, Eljamri S, Shaffer A, Padia R. Post-operative Challenges in Pediatric Tracheostomy: Exploring Granulation Tissue Formation, Complications, and the Potential Role of Ciprofloxacin\/Dexamethasone. 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