ABSTRACT
OBJECTIVES: To determine the antibiotic prescribing practices of pediatric residents and assess how they acquire knowledge leading to prescribing behaviors. METHODS: We performed a cross-sectional electronic survey of all pediatric residents at the Children's National Medical Center and Nicklaus Children's Hospital, assessing antibiotic prescribing patterns for common pediatric infections, use of antibiograms, and factors influencing antibiotic choice. RESULTS: Eighty-five surveys (45%) were returned complete and included in the analysis. Increased deviations from clinical guideline recommendations were observed for antibiotic treatments of sinusitis and community-acquired pneumonia as compared with otitis media and group A streptococcal pharyngitis. Only 57% of residents reported having used antibiograms. General pediatric inpatient attending physicians were identified as the most influential source for house staff antibiotic knowledge. CONCLUSIONS: Results illustrate the need for better promotion and integration of clinical guidelines with antibiograms when developing antibiotic education programs for residents in training. In addition, pediatric hospitalists should play an active role in the implementation of these programs and can provide valuable insight into the development of educational programs in conjunction with graduate medical education divisions.
Subject(s)
Antimicrobial Stewardship/methods , Drug Prescriptions/standards , Internship and Residency , Pediatrics , Practice Patterns, Physicians' , Cross-Sectional Studies , Drug Prescriptions/statistics & numerical data , Health Care Surveys , HumansSubject(s)
Knee Injuries/diagnosis , Athletic Injuries/diagnosis , Athletic Injuries/therapy , Bursitis/diagnosis , Bursitis/therapy , Cumulative Trauma Disorders/diagnosis , Cumulative Trauma Disorders/therapy , Fractures, Bone/diagnosis , Fractures, Bone/therapy , Humans , Knee Injuries/therapy , Knee Joint/anatomy & histology , Medical History Taking , Osteochondrosis/diagnosis , Osteochondrosis/therapy , Patellofemoral Pain Syndrome/diagnosis , Patellofemoral Pain Syndrome/therapy , Physical ExaminationSubject(s)
Gastroenteritis/therapy , Acute Disease , Antidiarrheals/administration & dosage , Child, Preschool , Combined Modality Therapy , Dehydration/therapy , Diagnosis, Differential , Diarrhea, Infantile/etiology , Diarrhea, Infantile/therapy , Feeding Behavior , Fluid Therapy/methods , Gastroenteritis/etiology , Humans , Infant , Patient Admission , Probiotics/administration & dosage , Rotavirus Infections/diagnosis , Rotavirus Infections/therapy , Vomiting/therapy , Zinc/administration & dosageSubject(s)
Pharyngitis , Anti-Bacterial Agents/therapeutic use , Bacterial Infections/complications , Bacterial Infections/diagnosis , Bacterial Infections/drug therapy , Child , Diagnosis, Differential , Humans , Pharyngitis/complications , Pharyngitis/diagnosis , Pharyngitis/drug therapy , Respiratory Tract Infections/complications , Respiratory Tract Infections/diagnosis , Respiratory Tract Infections/drug therapy , Virus Diseases/complications , Virus Diseases/diagnosis , Virus Diseases/drug therapyABSTRACT
An alcohol-naive 16-year-old male is presented with alcohol-induced atrial fibrillation. Past medical history, review of systems, and presentation were all otherwise benign. Atrial fibrillation occurred early in the intoxication at an alcohol level slightly higher than the legal limit for intoxication (153 mg/dL). His complete cardiac evaluation was otherwise normal. The atrial fibrillation was not treated aggressively and resolved as the alcohol level quickly fell to zero, consistent with his "nonalcoholic" metabolism. Complete follow-up found the adolescent with no evidence of cardiac or other disease.
