Narrow-Spectrum Antibiotic Use for CAP Up After Guideline Implementation
A study in Pediatrics states that use of narrow-spectrum antibiotics for the treatment of childhood community-acquired pneumonia (CAP) increased following new recommendations and active hospital-based efforts to distribute these guidelines.
In 2011, national guidelines by the Pediatric Infectious Disease Society and the Infectious Diseases Society of America recommend narrow-spectrum antibiotics such as ampicillin, rather than broad-spectrum antibiotics, for the management of childhood CAP. Derek Williams, MD, MPH, of the Vanderbilt University Medical Center, and colleagues designed a study spanning from January 1, 2010 to June 30, 2012 at three hospitals in Tennessee and Utah; two of the three hospitals had implemented active dissemination efforts to distribute the guidelines. A total of 2,121 children hospitalized with clinical and radiographic CAP were included in the research.
Prior to the dissemination of the guidelines, 52.8% of children with CAP received third-generation cephalosporins and only 2.7% received penicillin/ampicillin. In comparison, nine months following the guidelines, cephalosporin use dropped from 57.3% to 44.8% while penicillin/ampicillin use increased from 3.9% to 15.2%. Only the two hospitals that actively disseminated the guidelines had statistically significant declines in cephalosporin prescribing.
Previous research has shown similar clinical outcomes with narrow- and broad-spectrum antibiotics in treating childhood CAP. The authors of this study emphasize that targeted hospital-based efforts are key for swift implementation of guideline recommendations.
For more information visit Vanderbilt.edu.