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儿科抗生素在私人急诊中心治疗 RTI 的处方和使用情况。

Pediatric Antibiotic Prescribing and Utilization Practices for RTIs at Private Urgent Care Centers.

机构信息

Tonawanda Pediatrics, Buffalo, NY, USA.

Division of Pediatric Medical Education, Department of Pediatrics, University at Buffalo, State University of New York, Buffalo, NY, USA.

出版信息

Clin Pediatr (Phila). 2022 Dec;61(12):830-839. doi: 10.1177/00099228221106554. Epub 2022 Jun 27.

Abstract

Data on pediatric antibiotic prescribing and utilization practices at urgent care centers (UCC) remain limited. In this study, an electronic medical record-based review of UCC encounters for respiratory tract infections (RTI) of patients belonging to one mid-sized pediatric practice was performed. Antibiotic prescribing and guideline adherence were compared between UCCs that were staffed exclusively by pediatric-trained providers to those staffed otherwise. Of a total of 457 RTI visits, 330 (72%) occurred at the pediatric UCC. Across all bacterial RTIs, 82% of encounters at the pediatric UCC were guideline-adherent versus 59% at nonpediatric UCCs ( < .001). At nonpediatric UCCs, pharyngitis was the most common RTI encounter diagnosis (40%), and full streptococcal management guideline adherence was 41%. While 93% of RTI-UCC encounters for <2 years were at pediatric UCCs, the majority of children >10 presented to nonpediatric UCCs. RTI guideline education to UCCs should be a focus of ambulatory stewardship efforts.

摘要

有关急救中心(UCC)儿科抗生素处方和使用实践的数据仍然有限。在这项研究中,对属于一家中等规模儿科实践的患者的呼吸道感染(RTI)UCC 就诊进行了基于电子病历的回顾。比较了仅由儿科培训医生提供服务的 UCC 和其他医生提供服务的 UCC 之间的抗生素处方和指南遵守情况。在总共 457 例 RTI 就诊中,有 330 例(72%)发生在儿科 UCC。在所有细菌性 RTI 中,儿科 UCC 的符合指南的就诊比例为 82%,而非儿科 UCC 为 59%(<0.001)。在非儿科 UCC,咽炎是最常见的 RTI 就诊诊断(40%),完全遵守链球菌管理指南的比例为 41%。虽然<2 岁的 RTI-UCC 就诊中 93%在儿科 UCC,但大多数>10 岁的儿童就诊于非儿科 UCC。UCC 应成为门诊管理努力的重点,以进行 RTI 指南教育。

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