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A quality improvement initiative at pediatric ERs nearly quintupled the rate of children receiving shorter antibiotic courses for pneumonia and sinus infections. By updating order sets, sharing peer prescribing data, and enlisting frontline physician champions, the program shifted practice without increasing treatment failures or return visits. Fewer antibiotic days means less resistance risk, fewer side effects, and lower costs for families.
A quality improvement project published in Pediatrics shows that pediatric emergency departments can dramatically shift antibiotic prescribing habits — without compromising patient outcomes. The study, conducted across two academic pediatric ERs in Missouri and Kansas, found that combining EHR order set changes, peer comparison feedback, and frontline clinician champions nearly quintupled the proportion of children receiving shorter, evidence-based antibiotic courses for pneumonia and sinusitis.
Before the intervention, only 13.8% of pneumonia cases and 5.4% of sinusitis cases received guideline-aligned shorter courses. After the initiative, those rates jumped to 64.4% and 66.9%, respectively — with no meaningful increase in return visits within 14 days.
By the Numbers:
Why it matters: Prolonged antibiotic courses in children raise risks for antibiotic resistance, side effects, and unnecessary costs. This study proves that with the right tools and champions, shorter — and equally effective — treatment can become the new standard of care.
