{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,2]],"date-time":"2026-09-02T02:02:03Z","timestamp":1788314523179,"version":"build-2803163510"},"reference-count":19,"publisher":"American Academy of Pediatrics (AAP)","issue":"1","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2023,7,1]]},"abstract":"<jats:sec>\n                  <jats:title>BACKGROUND AND OBJECTIVES<\/jats:title>\n                  <jats:p>The majority of pediatric patients present to community-hospital emergency departments (EDs). Pneumonia is among the most common reasons for ED visits; however, prescribing narrow-spectrum antibiotics occurs at rates below established best practices. We sought to increase prescription of narrow-spectrum antibiotics for pediatric pneumonia in 5 community hospital EDs using an interdisciplinary learning collaborative. We aimed to increase use of narrow spectrum antibiotics from 60% to 80% by December 2018.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>METHODS<\/jats:title>\n                  <jats:p>A collaborative of 5 community hospitals developed quality improvement teams who held quarterly meetings over a 1 year period engaging teams in Plan-Do-Study-Act cycles. Interventions included deployment of an evidenced based guideline, educational interventions, and order set modification. Preintervention data were collected for 12 months. Using a standardized data form, teams collected monthly data during the intervention period and for an additional year after to assess for sustainability. Teams evaluated data using statistical process control charts and included any patient 3 months to 18 years with a diagnosis of pneumonia.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>RESULTS<\/jats:title>\n                  <jats:p>The aggregated rate of narrow-spectrum antibiotic prescriptions increased from 60% during the baseline period to 78% during the intervention period. During the year after active implementation, this aggregate rate increased to 92%. Differences in prescribing patterns were noted by provider type, but narrow-spectrum antibiotic use improved for both general emergency medicine and pediatric providers. No return visits to the ED for failure of antibiotic treatment within 72 hours occurred.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>CONCLUSIONS<\/jats:title>\n                  <jats:p>An interdisciplinary community hospital learning collaborative increased prescribing narrow-spectrum antibiotics by both general and pediatric ED providers.<\/jats:p>\n               <\/jats:sec>","DOI":"10.1542\/peds.2022-059201","type":"journal-article","created":{"date-parts":[[2023,6,7]],"date-time":"2023-06-07T08:09:59Z","timestamp":1686125399000},"source":"Crossref","is-referenced-by-count":6,"title":["Improving Use of Antibiotics for Pediatric Pneumonia in Community Hospital Emergency Departments"],"prefix":"10.1542","volume":"152","author":[{"given":"Melissa","family":"Sundberg","sequence":"first","affiliation":[{"name":"aDivision of Emergency Medicine"},{"name":"bDepartment of Pediatrics"},{"name":"cHarvard Medical School, Boston, Massachusetts"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jessica R.","family":"Sexton","sequence":"additional","affiliation":[{"name":"dNursing and Patient Care Operations, Boston Children\u2019s Hospital, Boston, Massachusetts"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Alla","family":"Smith","sequence":"additional","affiliation":[{"name":"bDepartment of Pediatrics"},{"name":"cHarvard Medical School, Boston, Massachusetts"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sara L.","family":"Toomey","sequence":"additional","affiliation":[{"name":"bDepartment of Pediatrics"},{"name":"cHarvard Medical School, Boston, Massachusetts"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"417","published-online":{"date-parts":[[2023,6,7]]},"reference":[{"key":"2023111414265487300_B1","doi-asserted-by":"crossref","first-page":"j686","DOI":"10.1136\/bmj.j686","article-title":"Community acquired pneumonia in children","volume":"356","author":"Haq","year":"2017","journal-title":"BMJ"},{"issue":"7","key":"2023111414265487300_B2","doi-asserted-by":"crossref","first-page":"e25","DOI":"10.1093\/cid\/cir531","article-title":"The management of community-acquired pneumonia in infants and children older than 3 months of age: clinical practice guidelines by the Pediatric Infectious Diseases Society and the Infectious Diseases Society of America","volume":"53","author":"Bradley","year":"2011","journal-title":"Clin Infect Dis"},{"issue":"2","key":"2023111414265487300_B3","doi-asserted-by":"crossref","first-page":"190","DOI":"10.1001\/jamapediatrics.2018.4270","article-title":"Comparison of antibiotic prescribing for pediatric community-acquired pneumonia in children\u2019s and non-children\u2019s hospitals","volume":"173","author":"Tribble","year":"2019","journal-title":"JAMA Pediatr"},{"issue":"6","key":"2023111414265487300_B4","doi-asserted-by":"crossref","first-page":"527","DOI":"10.1001\/jamapediatrics.2015.138","article-title":"A national assessment of pediatric readiness of emergency departments","volume":"169","author":"Gausche-Hill","year":"2015","journal-title":"JAMA Pediatr"},{"issue":"6","key":"2023111414265487300_B5","doi-asserted-by":"crossref","first-page":"783","DOI":"10.1016\/j.jpeds.2008.05.025","article-title":"Quality of care of children in the emergency department: association with hospital setting and physician training","volume":"153","author":"Dharmar","year":"2008","journal-title":"J Pediatr"},{"issue":"1","key":"2023111414265487300_B6","doi-asserted-by":"crossref","first-page":"1","DOI":"10.1542\/peds.2019-2203","article-title":"Trends in capability of hospitals to provide definitive acute care for children: 2008 to 2016","volume":"145","author":"Michelson","year":"2020","journal-title":"Pediatrics"},{"issue":"2","key":"2023111414265487300_B7","first-page":"159","article-title":"Management of pediatric skin abscesses in pediatric, general academic and community emergency departments","volume":"12","author":"Baumann","year":"2011","journal-title":"West J Emerg Med"},{"issue":"2","key":"2023111414265487300_B8","first-page":"1","article-title":"Antibiotic prescribing for children in United States emergency departments: 2009-2014","volume":"143","author":"Poole","year":"2020","journal-title":"Pediatrics"},{"key":"2023111414265487300_B9","unstructured":"Institute for Healthcare Improvement\n          . 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