Impact of a Personalized Audit and Feedback Intervention on Antibiotic Prescribing Practices for Outpatient Pediatric Community-Acquired Pneumonia
Impact of a Personalized Audit and Feedback Intervention on Antibiotic Prescribing Practices for Outpatient Pediatric Community-Acquired Pneumonia
复制标题
DOI：
10.1177/0009922820928054
复制
发表时间：
2020-06-02
影响因子：
1.6
通讯作者：
Werk, Lloyd N.
中科院分区：
文献类型：
--
作者：
Diaz, Maria Carmen G.;Handy, Lori K.;Werk, Lloyd N.
儿科社区获得性肺炎（CAP）的抗生素选择差异很大。我们旨在确定为期6个月的个性化审核和反馈计划对初级保健提供者CAP抗生素处方实践的影响。干预组的参与者每月收到个性化反馈。然后，我们分析了登记的供应商的CAP抗生素处方实践。参与者诊断出316例不同的CAP病例（214例对照，102例干预）;在这316例参与者中，301例接受抗生素治疗（207例对照，94例干预）。在年龄≥ 5岁的患者中，干预组使用的非指南一致性抗生素较少（对照组22/103 [21.4%];干预组3/51 [5.9%]，P <0.05），而使用的指南一致性抗生素（阿莫西林和阿奇霉素）较多。个性化，定期审计和反馈在门诊设置是可行的，并有积极的影响，临床医生的选择指南推荐的抗生素。审计和反馈应与其他抗菌药物管理干预措施相结合，以提高门诊CAP管理中的指南依从性。
Antibiotic choice for pediatric community-acquired pneumonia (CAP) varies widely. We aimed to determine the impact of a 6-month personalized audit and feedback program on primary care providers' antibiotic prescribing practices for CAP. Participants in the intervention group received monthly personalized feedback. We then analyzed enrolled providers' CAP antibiotic prescribing practices. Participants diagnosed 316 distinct cases of CAP (214 control, 102 intervention); among these 316 participants, 301 received antibiotics (207 control, 94 intervention). In patients >= 5 years, the intervention group had fewer non-guideline-concordant antibiotics prescribed (22/103 [21.4%] control; 3/51 [5.9%] intervention, P < .05) and received more of the guideline-concordant antibiotics (amoxicillin and azithromycin). Personalized, scheduled audit and feedback in the outpatient setting was feasible and had a positive impact on clinician's selection of guideline-recommended antibiotics. Audit and feedback should be combined with other antimicrobial stewardship interventions to improve guideline adherence in the management of outpatient CAP.