American Journal of Medical Quality

 

Advanced Search

Journal Navigation

Journal Home

Subscriptions

Archive

Contact Us

Table of Contents

Register here to gain access to SAGE's 500+ Journals Online

Click here to sign up for SAGE Journal Email Alerts today!

Sign In to gain access to subscriptions and/or personal tools.
This Article
Right arrow Full Text (PDF)
Right arrow References
Right arrow Alert me when this article is cited
Right arrow Alert me if a correction is posted
Right arrow Citation Map
Services
Right arrow Email this article to a friend
Right arrow Similar articles in this journal
Right arrow Similar articles in PubMed
Right arrow Alert me to new issues of the journal
Right arrow Add to Saved Citations
Right arrow Download to citation manager
Right arrowRequest Permissions
Right arrow Request Reprints
Right arrow Add to My Marked Citations
Citing Articles
Right arrow Citing Articles via HighWire
Right arrow Citing Articles via Google Scholar
Google Scholar
Right arrow Articles by Wilson, S. D.
Right arrow Articles by Wells, R. D.
Right arrow Search for Related Content
PubMed
Right arrow PubMed Citation
Right arrow Articles by Wilson, S. D.
Right arrow Articles by Wells, R. D.
Social Bookmarking
Add to CiteULike   Add to Connotea   Add to Del.icio.us   Add to Digg   Add to Reddit   Add to Technorati  
What's this?
American Journal of Medical Quality, Vol. 17, No. 5, 195-199 (2002)
DOI: 10.1177/106286060201700507

An Evidence-Based Clinical Pathway for Bronchiolitis Safely Reduces Antibiotic Overuse

Stephen D. Wilson, MD, PhD

Department of Pediatrics, University of California, San Francisco, Calif, swilson{at}itsa.ucsf.edu

Barbara B. Dahl, MA

Department of Research, Children's Hospital Central California, Fresno, Calif

Robert D. Wells, PhD

Department of Research, Children's Hospital Central California

The overuse of antibiotics in the management of bronchiolitis is widely known, yet physician practice has been slow to change. We report here on the success of a clinical pathway in reducing antibiotic overuse in the inpatient management of bronchiolitis. The charts of 181 children admitted for bronchiolitis were reviewed to determine whether antibiotic use was reduced in patients managed using a clinical pathway compared with a matched group of patients managed without use of the pathway (non-pathway group). Only 9% of the pathway patients received antibiotics compared with 27% of the nonpathway group. No negative effects were seen on other quality measures including unplanned return for care. Furthermore, for patients managed using the clinical pathway, cost and length of stay were significantly reduced. Overall, the study suggests that implementation of a clinical pathway may be an effective means to change physician practice and reduce the unnecessary use of antibiotics, while maintaining or improving other aspects of quality of care.

Key Words: Antibiotics • bronchiolitis • clinical pathway • pediatrics • steroids


Add to CiteULike CiteULike   Add to Connotea Connotea   Add to Del.icio.us Del.icio.us   Add to Digg Digg   Add to Reddit Reddit   Add to Technorati Technorati    What's this?


This article has been cited by other articles:


Home page
 PediatricsHome page
D. A. Christakis, C. A. Cowan, M. M. Garrison, R. Molteni, E. Marcuse, and D. M. Zerr
Variation in Inpatient Diagnostic Testing and Management of Bronchiolitis
Pediatrics, April 1, 2005; 115(4): 878 - 884.
[Abstract] [Full Text] [PDF]

Home page
 American Journal of Medical QualityHome page
D. A. Lemberg, A. S. Day, and M. Brydon
The Role of a Clinical Pathway in Curtailing Unnecessary Investigations in Children With Gastroenteritis
American Journal of Medical Quality, March 1, 2005; 20(2): 83 - 89.
[Abstract] [PDF]

Home page
 Arch Pediatr Adolesc MedHome page
E. O. Doyne, M. P. Alfaro, R. M. Siegel, H. D. Atherton, P. J. Schoettker, J. Bernier, and U. R. Kotagal
A Randomized Controlled Trial to Change Antibiotic Prescribing Patterns in a Community
Arch Pediatr Adolesc Med, June 1, 2004; 158(6): 577 - 583.
[Abstract] [Full Text] [PDF]