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Bailey AM, Stephan M, Weant KA, et al. Dosing of Appropriate Antibiotics and Time to Administration of First Doses in the Pediatric Emergency Department. J Pediatr Pharmacol Ther. 2015;20(4):309-15doi: 10.5863/1551-6776-20.4.309.
Bailey, A. M., Stephan, M., Weant, K. A., & Justice, S. B. (2015). Dosing of Appropriate Antibiotics and Time to Administration of First Doses in the Pediatric Emergency Department. The journal of pediatric pharmacology and therapeutics : JPPT : the official journal of PPAG, 20(4), 309-15. https://doi.org/10.5863/1551-6776-20.4.309
Bailey, Abby M, et al. "Dosing of Appropriate Antibiotics and Time to Administration of First Doses in the Pediatric Emergency Department." The journal of pediatric pharmacology and therapeutics : JPPT : the official journal of PPAG vol. 20,4 (2015): 309-15. doi: https://doi.org/10.5863/1551-6776-20.4.309
Bailey AM, Stephan M, Weant KA, Justice SB. Dosing of Appropriate Antibiotics and Time to Administration of First Doses in the Pediatric Emergency Department. J Pediatr Pharmacol Ther. 2015 Jul-Aug;20(4):309-15. doi: 10.5863/1551-6776-20.4.309. PMID: 26380571; PMCID: PMC4557721.
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J Pediatr Pharmacol Ther. 2015 Jul-Aug;20(4):309-15. doi: 10.5863/1551-6776-20.4.309.

Dosing of Appropriate Antibiotics and Time to Administration of First Doses in the Pediatric Emergency Department.

The journal of pediatric pharmacology and therapeutics : JPPT : the official journal of PPAG

Abby M Bailey, Maria Stephan, Kyle A Weant, Stephanie Baker Justice

Affiliations

  1. Department of Pharmacy, University of Kentucky HealthCare, Lexington, Kentucky.
  2. Department of Emergency Medicine, St. Mary's Hospital, Richmond, Virginia.
  3. KentuckyOne Health, University of Louisville and Jewish Hospital, Louisville, Kentucky.

PMID: 26380571 PMCID: PMC4557721 DOI: 10.5863/1551-6776-20.4.309

Abstract

OBJECTIVES: Emergency department (ED) providers are faced with the challenge of diagnosing and treating patients in a timely fashion given many obstacles including limited patient information, complex disease states, and high patient turnover. Time delays in administration or selection of appropriate drug therapies have been associated with negative outcomes in severe infections. This study was conducted to assess the impact of an emergency medicine pharmacist (EPh) on the selection of appropriate antibiotics and the timeliness of administration in pediatric patients in the ED.

METHODS: Patients younger than 18 years were evaluated who were admitted through the ED and received 1 dose of intravenous antibiotic for the following conditions: community-acquired pneumonia, complicated skin and soft tissue infection (SSTI), meningitis, and sepsis. To evaluate the impact of the presence of an EPh, patients with orders placed during the EPh's hours of 1 pm and 11 pm were compared to those with an order placed between 11 pm and 1 pm.

RESULTS: A total of 142 patients were included in the study. Patients seen during EPh hours received an appropriate first antibiotic 93.4% of the time (p = 0.157) and second antibiotic 96.8% of the time (p = 0.023). Time from order to verification was significantly shorter for the first 2 antimicrobials in the EPh group (10.5 minutes [p = 0.003] and 11.4 minutes [p = 0.047], respectively). The days from discharge to return to readmission to the ED were also significantly different (17.5 days vs. 62.4 days, p = 0.008).

CONCLUSIONS: The available data suggest that patients are more likely to receive appropriate doses of antimicrobials, and in a more timely fashion, whenever the EPh is present. Areas for future investigation include whether the presence of EPhs at the bedside has the potential to impact areas of patient care, including readmission rates, drug costs, and medication errors.

Keywords: adverse reactions; antibiotic; emergency medicine; medication errors; pediatrics

References

  1. Crit Care Med. 2010 Apr;38(4):1045-53 - PubMed
  2. Pediatrics. 2002 Oct;110(4):737-42 - PubMed
  3. Arch Intern Med. 2004 Mar 22;164(6):637-44 - PubMed
  4. Am J Hosp Pharm. 1988 Sep;45(9):1902-3 - PubMed
  5. Crit Care Med. 1988 Nov;16(11):1110-6 - PubMed
  6. Pediatrics. 2007 Jan;119(1):e77-85 - PubMed
  7. Pediatr Cardiol. 2008 Jul;29(4):744-8 - PubMed
  8. Crit Care Med. 2002 Apr;30(4):919-21 - PubMed
  9. Clin Infect Dis. 2004 Nov 1;39(9):1267-84 - PubMed
  10. Clin Infect Dis. 2005 Nov 15;41(10):1373-406 - PubMed
  11. JAMA. 2001 Apr 25;285(16):2114-20 - PubMed
  12. Pediatr Emerg Care. 2009 Jul;25(7):444-6 - PubMed
  13. Clin Infect Dis. 2011 Oct;53(7):e25-76 - PubMed
  14. JAMA. 1999 Jul 21;282(3):267-70 - PubMed
  15. Clin Infect Dis. 2008 Aug 1;47(3):303-27 - PubMed
  16. J Pharm Pract. 2013 Apr;26(2):125-30 - PubMed
  17. Crit Care Med. 2006 Jun;34(6):1589-96 - PubMed
  18. Ann Emerg Med. 2012 May;59(5):369-73 - PubMed

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