Tonawanda Pediatrics, Buffalo, NY, USA.
Division of Pediatric Medical Education, Department of Pediatrics, University at Buffalo, State University of New York, Buffalo, NY, USA.
Clin Pediatr (Phila). 2022 Dec;61(12):830-839. doi: 10.1177/00099228221106554. Epub 2022 Jun 27.
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.
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。
