2024
Improving Guideline-Concordant Care for Febrile Infants Through a Quality Improvement Initiative.
McDaniel C, Kerns E, Jennings B, Magee S, Biondi E, Flores R, Aronson P. Improving Guideline-Concordant Care for Febrile Infants Through a Quality Improvement Initiative. Pediatrics 2024, 153 PMID: 38682245, DOI: 10.1542/peds.2023-063339.Peer-Reviewed Original ResearchMeSH KeywordsAnti-Bacterial AgentsCanadaFemaleFeverGuideline AdherenceHumansInfantInfant, NewbornMalePractice Guidelines as TopicQuality ImprovementUnited StatesConceptsClinical practice guidelinesFebrile infantsAmerican Academy of Pediatrics clinical practice guidelineSecondary measuresAAP clinical practice guidelinesPediatrics clinical practice guidelineInvasive bacterial infectionsQI collaborativeIntervention bundleAdherence to specific recommendationsDischarge of infantsGuideline-concordant careInfants aged 8Clinical practice guideline recommendationsPrimary measureQuality improvementOral antibioticsEmergency department dischargePositive urinalysisAssociated with improvementsQualifying infantsQuality improvement initiativesAdministered antibioticsGuideline recommendationsCerebrospinal fluid
2022
Disparities and implicit bias in the management of low-risk febrile infants: a mixed methods study protocol
Gutman C, Lion K, Aronson P, Fisher C, Bylund C, McFarlane A, Lou X, Patterson M, Lababidi A, Fernandez R. Disparities and implicit bias in the management of low-risk febrile infants: a mixed methods study protocol. BMJ Open 2022, 12: e063611. PMID: 36127098, PMCID: PMC9490627, DOI: 10.1136/bmjopen-2022-063611.Peer-Reviewed Original ResearchConceptsLow-risk febrile infantsFebrile infantsEmergency departmentClinical carePediatric Emergency Medicine Collaborative Research CommitteeFlorida Institutional Review BoardLocal institutional review board approvalPediatric ED physiciansInstitutional review board approvalMultivariable logistic regressionCross-sectional studyPhysician-patient communicationReview board approvalClinical guideline implementationMethods study protocolInstitutional review boardMulticenter analysisPrimary outcomeED physiciansPhysician assessmentRecommended careGuideline implementationLumbar punctureStudy protocolEmergency settingVariation in bacterial pneumonia diagnoses and outcomes among children hospitalized with lower respiratory tract infections
Cotter J, Hall M, Shah S, Molloy M, Markham J, Aronson P, Stephens J, Steiner M, McCoy E, Collins M, Tchou M. Variation in bacterial pneumonia diagnoses and outcomes among children hospitalized with lower respiratory tract infections. Journal Of Hospital Medicine 2022, 17: 872-879. PMID: 35946482, PMCID: PMC11366396, DOI: 10.1002/jhm.12940.Peer-Reviewed Original ResearchConceptsBacterial community-acquired pneumoniaLower respiratory tract infectionsCommunity-acquired pneumoniaRespiratory tract infectionsProportion of childrenTract infectionsDiagnosis groupsMulticenter cross-sectional studyLength of stayCross-sectional studyCause revisitsClinical outcomesBlood testsChildren's HospitalViral causeCaP diagnosisChest radiographsMAIN OUTCOMEMultivariable regressionPneumonia diagnosisHospitalDiagnosisOutcomesReadmissionSignificant differencesPrevalence and Management of Invasive Bacterial Infections in Febrile Infants Ages 2 to 6 Months
Green R, Sartori L, Lee B, Linn A, Samuels M, Florin T, Aronson P, Chamberlain J, Michelson K, Nigrovic L. Prevalence and Management of Invasive Bacterial Infections in Febrile Infants Ages 2 to 6 Months. Annals Of Emergency Medicine 2022, 80: 499-506. PMID: 35940993, DOI: 10.1016/j.annemergmed.2022.06.014.Peer-Reviewed Original ResearchMeSH KeywordsAnti-Bacterial AgentsBacteriaBacterial InfectionsCase-Control StudiesFeverHumansInfantInfant, NewbornPrevalenceRetrospective StudiesConceptsInvasive bacterial infectionsCase-control studyBacterial infectionsFebrile infantsInfants 2Emergency departmentEligible patient encountersOlder febrile infantsCerebrospinal fluid culturesInfection prevalenceAge-matched infantsEvidence-based guidelinesInfants ages 2Months of ageLow-value testingFebrile neonatesOverall cohortRetrospective cohortSecondary outcomesPrimary outcomeAntibiotic administrationBacterial cultureFluid cultureCerebrospinal fluidLower risk
2018
Factors Associated with Adverse Outcomes among Febrile Young Infants with Invasive Bacterial Infections
Pruitt CM, Neuman MI, Shah SS, Shabanova V, Woll C, Wang ME, Alpern ER, Williams DJ, Sartori L, Desai S, Leazer RC, Marble RD, McCulloh RJ, DePorre AG, Rooholamini SN, Lumb CE, Balamuth F, Shin S, Aronson PL, Collaborative F, Nigrovic L, Browning W, Mitchell C, Peaper D, Feldman E. Factors Associated with Adverse Outcomes among Febrile Young Infants with Invasive Bacterial Infections. The Journal Of Pediatrics 2018, 204: 177-182.e1. PMID: 30297292, PMCID: PMC6309646, DOI: 10.1016/j.jpeds.2018.08.066.Peer-Reviewed Original ResearchMeSH KeywordsAnti-Bacterial AgentsBacteremiaCohort StudiesFemaleFeverHumansInfantInfant MortalityInfant, NewbornMaleMeningitis, BacterialRetrospective StudiesRisk FactorsConceptsInvasive bacterial infectionsFebrile young infantsAdverse outcomesBacterial meningitisYoung infantsIll appearanceFebrile infantsBacterial infectionsRetrospective cohort studyMedical record reviewLocal microbiology laboratoryMixed-effects logistic regressionElectronic medical record systemDays of ageIll appearingNeurologic sequelaeCohort studyMedical record systemClinical factorsMedication receiptMechanical ventilationRecord reviewClinical dataInclusion criteriaMeningitisEpidemiology and Etiology of Invasive Bacterial Infection in Infants ≤60 Days Old Treated in Emergency Departments
Woll C, Neuman MI, Pruitt CM, Wang ME, Shapiro ED, Shah SS, McCulloh RJ, Nigrovic LE, Desai S, DePorre AG, Leazer RC, Marble RD, Balamuth F, Feldman EA, Sartori LF, Browning WL, Aronson PL, Collaborative F, Alpern E, Hayes K, Lee B, Lumb C, Mitchell C, Peaper D, Rooholamini S, Shin S, Williams D. Epidemiology and Etiology of Invasive Bacterial Infection in Infants ≤60 Days Old Treated in Emergency Departments. The Journal Of Pediatrics 2018, 200: 210-217.e1. PMID: 29784512, PMCID: PMC6109608, DOI: 10.1016/j.jpeds.2018.04.033.Peer-Reviewed Original ResearchConceptsInvasive bacterial infectionsThird-generation cephalosporinsMicrobiology laboratory databaseEmergency departmentBacterial infectionsBacterial meningitisPediatric emergency departmentCombination of ampicillinAntimicrobial treatment regimenCross-sectional studyGroup B streptococciElectronic medical record systemEmpiric treatmentMedical record systemTreatment regimenChildren's HospitalMost infantsMedical recordsB streptococciCerebrospinal fluidCommon pathogensInfantsAntimicrobial susceptibilityDay oldsInfection
2015
Association of clinical practice guidelines with emergency department management of febrile infants ≤56 days of age
Aronson PL, Thurm C, Williams DJ, Nigrovic LE, Alpern ER, Tieder JS, Shah SS, McCulloh RJ, Balamuth F, Schondelmeyer AC, Alessandrini EA, Browning WL, Myers AL, Neuman MI, Collaborative F. Association of clinical practice guidelines with emergency department management of febrile infants ≤56 days of age. Journal Of Hospital Medicine 2015, 10: 358-365. PMID: 25684689, PMCID: PMC4456211, DOI: 10.1002/jhm.2329.Peer-Reviewed Original ResearchMeSH KeywordsAnti-Bacterial AgentsBlood Chemical AnalysisCeftriaxoneCerebrospinal FluidCost ControlCross-Sectional StudiesEmergency Service, HospitalFeverGuideline AdherenceHealth Care SurveysHealth Information SystemsHospitals, PediatricHumansInfantInfant, NewbornPractice Guidelines as TopicRetrospective StudiesUnited StatesUrinalysisConceptsClinical practice guidelinesCeftriaxone useCPG recommendationsInfants 29CSF testingHealthcare costsED dischargeFebrile infantsPractice guidelinesInstitutional clinical practice guidelinePediatric Health Information SystemRetrospective cross-sectional studyCerebrospinal fluid testingEmergency department managementCross-sectional studyLower healthcare costsRate of urineDiagnosis of feverDays of ageED visitsPractice variationDepartment managementAge groupsHealth information systemsFluid testing