A recently published approach to the treatment of pediatric community-acquired pneumonia offers a low-cost, low-risk step on the way toward a treatment plan and indicates that treatment guidelines are effective in changing treatment plans, according to the study investigators.
Michael J. Smith, MD, MSCE, and colleagues from the departments of pediatrics and biostatistics at the University of Louisville in Kentucky reviewed records for 1,246 children who had a primary pneumonia diagnosis from 2007 to 2009. The researchers measured monthly antimicrobial agent use to determine how effective guidelines and education for use of antibiotics were on actual therapy outcomes. Researchers reported that use of antibiotics was measured during three periods: 1) before the creation of an antimicrobial stewardship task force (ASTF); 2) after the task force was created but before release of antimicrobial guidelines; and 3) after guidelines were released.
Smith and colleagues reported that “ampicillin use increased from 2% at baseline to 6% after ASTF formation and 44% after guideline release.” In addition, after the release of the guidelines, ceftriaxone use decreased to 28%.
Smith and colleagues reported an immediate change in prescription in the month after the guideline publication that remained stable during the following year. Given the current state of antimicrobial overuse, adherence to guidelines is essential in preserving antimicrobial agent effectiveness and treating diseases such as community-acquired pneumonia, the researchers said, adding that their guidelines were still being observed by practitioners 1 year after they were released.
“Although the optimal strategies for pediatric antimicrobial stewardship are still being determined, we believe our approach offers a low-risk step in the right direction for centers that currently lack the time and resources to develop a formal [antimicrobial stewardship] as outlined by the IDSA,” the researchers concluded.
Disclosure: Dr. Smith reports no relevant financial disclosures.