Increasing Guideline-Recommended Antibiotic Therapy for Community-Acquired Pneumonia in the Outpatient Setting
The “Increasing Guideline-Recommended Antibiotic Therapy for Community-Acquired Pneumonia in the Outpatient Setting” project, led by Lilliam Ambroggio, PhD, sought to increase guideline recommended antibiotic therapy from a baseline of 30% to 80% in 10 community-practice settings. Interventions focused on the following key drivers: increased provider buy-in, effective communication between providers, and accurate knowledge of the guideline. Data from 1,998 youth participants diagnosed with community-acquired pneumonia showed:
- An increase in ED visits after implementing the intervention (1.5% pre-intervention vs. 2.9% post-intervention, p-value=0.04)
- A 75% mean increase in guideline-recommended therapy for children diagnosed with community-acquired pneumonia
These results indicate that Quality Improvement (QI) methods are effective in rapidly implementing a new guideline in community settings, but interventions with high reliability are difficult to implement and sustain. Increasing guideline- recommended antibiotic therapy in the outpatient setting did not increase the overall proportion of children who returned for unscheduled visits. There was a statistical but not clinically significant increase in ED visits.
