Improving Antibiotic Use in Pediatric Preseptal Cellulitis Using a Clinical Practice Guideline

Author:

Cooper Brennen J.1,Mitchell Michelle L.12,Melamed Svetlana3,Liegl Melodee4,Pan Amy Y.4,Burek Alina G.12

Affiliation:

1. aDepartment of Pediatrics, Medical College of Wisconsin

2. bChildren’s Wisconsin, Milwaukee, Wisconsin; and

3. cChildren’s Minnesota, Minneapolis, Minnesota

4. dDepartment of Pediatrics, Division of Quantitative Health Services, Medical College of Wisconsin, Milwaukee, Wisconsin

Abstract

OBJECTIVES: The purpose of this study was to evaluate the impact of a clinical practice guideline (CPG) on antibiotic use and resource utilization for pediatric preseptal cellulitis. METHODS: This retrospective quasiexperimental study included patients between the age of 2 months and 17 years admitted for preseptal cellulitis between January 2013 and December 2023. The preseptal cellulitis CPG was implemented in December 2020 using a multifaceted strategy that included buy-in from key stakeholders, education of frontline providers, the official CPG launch, and stakeholder check-ins. The primary outcome was the use of broad-spectrum antibiotics, including dual/triple therapy and methicillin-resistant Staphylococcus aureus (MRSA) active antibiotics. The secondary outcome was resource utilization including blood testing and imaging. Outcomes were compared pre- and post-CPG implementation using the Fisher exact test and logistic regressions. RESULTS: Of 236 patients meeting inclusion criteria, 175 and 61 patients composed the pre- and post-CPG cohorts, respectively. Median age (interquartile range) was 4.0 (1.8–8.3) years and 46% of the population were female. Post-CPG implementation changes in empirical antibiotic use included decreases in broad-spectrum use from 100% to 66% (P < .001), dual/triple therapy from 47% to 16% (P < .001), and MRSA active agents from 86% to 26% (P < .001). There was a decrease in complete blood count and blood culture orders from 75% to 57% (P = .014) and 32% to 18% (P = .047), respectively. CONCLUSIONS: Use of broad-spectrum antibiotics, including dual/triple therapy and MRSA active antibiotics for the treatment of pediatric preseptal cellulitis, decreased after CPG implementation.

Publisher

American Academy of Pediatrics (AAP)

Reference24 articles.

1. Periorbital and orbital cellulitis;Baiu;JAMA,2020

2. Preseptal cellulitis in children: a single-center experience;Cürebal;Sisli Etfal Hastan Tip Bul,2019

3. Pediatric preseptal and orbital cellulitis: a 10-year experience;Santos;Int J Pediatr Otorhinolaryngol,2019

4. Periorbital cellulitis in the era of Haemophilus influenzae type B vaccine: predisposing factors and etiologic agents in hospitalized children;Rimon,2008

5. Paediatric periorbital cellulitis: a 10-year retrospective case series review;Murphy;J Paediatr Child Health,2021

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