National Imaging and Antibiotic Practice Patterns in Children Presenting With Urinary Tract Infection to Community Practices: Little Impact From the American Academy of Pediatrics Guidelines?

{"article_title":"National Imaging and Antibiotic Practice Patterns in Children Presenting With Urinary Tract Infection to Community Practices: Little Impact From the American Academy of Pediatrics Guidelines?","author":"Inouye BM, Dionise ZR, Jiang R, Wolf S, Nicholl L, Pomann GM, Wiener JS, Purves JT, Routh JC","journal_title":"Clinical pediatrics","issn":"1938-2707","isbn":"","publication_date":"2019 Oct","volume":"58","issue":"11-Dec","first_page":"1302","page_count":"","accession_number":"31165627","doi":"10.1177\/0009922819853003","publisher":"Sage Publications","doctype":"Journal Article","subjects":"United States; Anti-Bacterial Agents therapeutic use; Community Health Services methods; Guideline Adherence statistics & numerical data; Health Care Surveys statistics & numerical data; Practice Patterns, Physicians' statistics & numerical data; Urinary Tract Infections drug therapy; Child; Cohort Studies; Female; Humans; Male; Pediatrics; Retrospective Studies; Societies, Medical; United States","interest_area":["Urology & Nephrology"," Infectious Disease & Vaccines"," Radiology"," Pediatric Medicine"," Internal\/Family Medicine"],"abstract":"Our objective was to use community-based, national databases to evaluate diagnostic imaging and antibiotic prophylaxis practice patterns before and after the release of the 2011 American Academy of Pediatrics guidelines for acute febrile urinary tract infection. Using the National Ambulatory and Hospital Ambulatory Medical Care Surveys, urinary tract infection encounters were identified for patients aged 2 months to 18 years. Primary outcomes were utilization of antibiotics (as proxy for prophylaxis) and diagnostic imaging during encounters. Weighted multivariate logistic regression models were used to examine the association between time period (before and after 2011) and each of the primary outcomes. Among 8 588 035 weighted encounters, adjusting for covariates, there was insufficient evidence to suggest a difference between time periods for antibiotic utilization (odds ratio = 0.66, P = .12) or diagnostic imaging (odds ratio = 1.16, P = .56). Thus, we did not find evidence of changes in antibiotic utilization or diagnostic imaging practice patterns after the release of the 2011 American Academy of Pediatrics guidelines.","url":"https:\/\/search.ebscohost.com\/login.aspx?direct=true&db=mdl&AN=31165627&authtype=shib&custid=ns346513","isPdfLink":true,"isSAML":false,"additionalInfo":{"Authored_By":"Inouye BM, Dionise ZR, Jiang R, Wolf S, Nicholl L, Pomann GM, Wiener JS, Purves JT, Routh JC","Journal_Info":"Publisher: Sage Publications Country of Publication: United States NLM ID: 0372606 Publication Model: Print-Electronic Cited Medium: Internet ISSN: 1938-2707 (Electronic) Linking ISSN: 00099228 NLM ISO Abbreviation: Clin Pediatr (Phila) Subsets: MEDLINE","Publication_Type":"Journal Article; Research Support, N.I.H., Extramural","Published_Date":"2019-10-01","Source":"Clinical pediatrics [Clin Pediatr (Phila)] 2019 Oct; Vol. 58 (11-12), pp. 1302-1308. Date of Electronic Publication: 2019 Jun 05.","Languages":"English","Electronic_ISSN":"1938-2707","MeSH_Terms":"Anti-Bacterial Agents\/*therapeutic use , Community Health Services\/*methods , Guideline Adherence\/*statistics & numerical data , Health Care Surveys\/*statistics & numerical data , Practice Patterns, Physicians'\/*statistics & numerical data , Urinary Tract Infections\/*drug therapy, Child ; Cohort Studies ; Female ; Humans ; Male ; Pediatrics ; Retrospective Studies ; Societies, Medical ; United States","Subjects":"Child, Cohort Studies, Female, Humans, Male, Pediatrics, Retrospective Studies, Societies, Medical, United States, Anti-Bacterial Agents therapeutic use, Community Health Services methods, Guideline Adherence statistics & numerical data, Health Care Surveys statistics & numerical data, Practice Patterns, Physicians' statistics & numerical data, Urinary Tract Infections drug therapy","Title_Abbreviations":"Clinical pediatrics","Volume":"58"},"header":{"DbId":"mdl","DbLabel":"MEDLINE Ultimate","An":"31165627","RelevancyScore":"836","PubType":"Academic Journal","PubTypeId":"academicJournal","PreciseRelevancyScore":"836.138916015625"},"plink":"https:\/\/search.ebscohost.com\/login.aspx?direct=true&site=eds-live&db=mdl&AN=31165627&authtype=shib&custid=ns346513&group=main&profile=eds","upload_link":"https:\/\/search.ebscohost.com\/login.aspx?direct=true&site=eds-live&db=mdl&AN=31165627&authtype=shib&custid=ns346513&group=main&profile=eds"}