Identifying successful pediatric outpatient antimicrobial stewardship strategies through benchmarking: A multi-institutional project - 24/11/25
, Joshua Herigon, MD, MPH, MBI a, b, Bethany A. Wattles, PharmD, MHA c, Matthew P. Kronman, MD, MSCE d, Michael J. Smith, MD, MSCE e, Sameer J. Patel, MD f, Nicole M. Poole, MD g, Rosemary Olivero, MD h, Ann L. Wirtz, PharmD, BCPPS i, j, Brian R. Lee, MPH, PhD a, bfor SHARPS-OP (Sharing Antimicrobial Reports for Pediatric Stewardship, OutPatient) Collaborative
Résumé |
Background |
We evaluated the impact of benchmarking on antibiotic prescribing and identified antibiotic stewardship strategies affecting pediatric outpatient antibiotic prescribing.
Methods |
The Sharing Antimicrobial Reports for Pediatric Stewardship-Outpatient Collaborative shared quarterly benchmarking reports with 22 institutions on antibiotic prescribing metrics (percentage of acute and acute respiratory infection [ARI] encounters with antibiotic prescriptions, duration of ≤ 7days, and among ARI, rates of amoxicillin and azithromycin use) for emergency departments, urgent care clinics, and primary care clinics. In January 2024, a survey assessed stewardship strategies and the impact of the benchmarking reports. We compared baseline (January 2019-December 2022) with the benchmarking period (January 2023-September 2024).
Results |
We included 32.4 million acute encounters. Although antibiotic prescribing increased in the benchmarking period, we saw increased amoxicillin use, decreased azithromycin use, and decreased antibiotic duration. The odds of receiving antibiotics for ARI were variable across practice settings and strategies, although institutions that used guidelines, electronic record features, and quality improvement projects observed lower antibiotic and azithromycin use and higher amoxicillin use.
Conclusions |
Although we did not observe a decrease in antibiotic prescribing for ARI after providing benchmarking reports, there was improvement in antibiotic selection. Guidelines and quality improvement initiatives may have the biggest impact on antibiotic prescribing metrics.
Le texte complet de cet article est disponible en PDF.Graphical abstract |
Highlights |
• | We shared antibiotic use benchmarking reports with 22 institutions nationally. |
• | We evaluated antibiotic use metrics in various outpatient settings. |
• | The benchmarking period had higher amoxicillin and lower azithromycin prescribing. |
• | Quality improvement initiatives and guidelines were associated with improved metrics. |
Abbreviations : ARI, AS, CDC, ED, EMR, PCC, QI, UC
Key Words : Outpatient antimicrobial stewardship, Pediatric, Ambulatory, Antibiotic prescribing metrics
Plan
| Prior presentation: This work was presented as an oral presentation at the Pediatric Academic Societies Meeting in Hawaii in April 2025, and as a poster at the 15th Annual ASP Conference in St Louis, MO. |
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| Funding/Support: This work was supported by the Heroes in Implementation Research Scholar Award from the Association for Professionals in Infection Control and Epidemiology. |
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| Conflicts of interest: REE receives investigator-initiated grant support from Merck on reducing health inequity in antimicrobial prescribing for respiratory infections. REE received an honorarium for reviewing grants for Pfizer in 2024. All other authors report no conflict of interest. |
Vol 53 - N° 12
P. 1313-1319 - décembre 2025 Retour au numéro
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