Methods: This retrospective chart review the aforementioned population who were admitted to the inpatient pediatric service via the ED from January 1, 2015 – December 1. 2017. Data collection included patient demographics, prior antibiotic use from an outside prescriber, the antimicrobial prescribed in the ED, and the antimicrobial used in the pediatric unit. The primary outcome determined the consistency between the prescribing pattern in the ED and the inpatient. A descriptive statistical analysis was conducted afterward.
Results: 210 patients were admitted to the inpatient pediatric service. The ED prescribed an aminopenicillin to 2.9% of patients or a cephalosporin as monotherapy to 70.9%; 0.9% of patients were started on both types. Once under the hospitalist’s service, the hospitalist continued the cephalosporin in 72.4%, switched to an aminopenicillin in 10.6%, switched to a macrolide in 5.4%, and 8.1% discontinued antimicrobrials altogether. If an aminopenicillin was started in the ED, it was continued by the hospitalist in 83.3% of the cases, with none switching to a cephalosporin, and 1 patient being switched to a macrolide.
Conclusion: At our local pediatric hospital, there is poor compliance with IDSA guidelines for CAP. There is high concordance between ED and in-patient prescribers since hospitalists were more likely to continue the antimicrobial started in the ED. Guideline adherence might be improved by focus on antibiotic stewardship and creating order sets that adhere to IDSA guidelines. Future studies could investigate if these suggestions improve overall adherence rates.
J. Fune, None