Antibiotic Stewardship for Children in the Emergency Department

Unnecessary antibiotic prescriptions are common and are a focus of quality improvement efforts. These authors used the 2009 to 2014 National Hospital Ambulatory Medical Care Surveys (NHAMCS) to examine antibiotic prescribing in pediatric and general emergency departments (EDs).

Of an estimated 29 million annual visits by children, 86% were in general (i.e., nonpediatric) EDs. Antibiotic administration, prescription, or continuation occurred in 23% of all pediatric visits. Among visits with antibiotics, 32% had diagnoses for which antibiotics are generally not indicated (e.g., bronchitis or bronchiolitis). Pediatric ED visits were more likely than general ED visits to use first-line, guideline-concordant therapy (87% vs. 77%). General ED visi…