title: Variation in hospital antibiotic prescribing practices for children with acute lymphoblastic leukemia.
abstract: Antibiotic variation among pediatric oncology patients has not been well-described. Identification of significant variability in antibiotic use within this population would warrant evaluation of its clinical impact. We conducted a retrospective cohort study of newly diagnosed patients with pediatric acute lymophoblastic leukemia (ALL) hospitalized from 1999 to 2009 in 39 freestanding US children's hospitals within the Pediatric Health Information System. Medication use data were obtained for the first 30 days from each patient's index ALL admission date. Antibiotic exposure rates were reported as antibiotic days/1000 hospital days. Unadjusted composite broad-spectrum antibiotic exposure rates varied from 577 to 1628 antibiotic days/1000 hospital days. This wide range of antibiotic exposure was unaffected by adjustment for age, gender, race and days of severe illness (adjusted range: 532-1635 days of antibiotic therapy/1000 hospital days). Antibiotic use for children with newly diagnosed ALL varies widely across children's hospitals and is not explained by demographics or illness severity.
authors.affiliation: Division of Infectious Diseases, The Children's Hospital of Philadelphia, Philadelphia, PA 19104, USA. fi sherbria@email.chop.edu
authors.forename: Brian T
authors.initials: BT
authors.lastname: Fisher
authors.forename: Jeffrey S
authors.initials: JS
authors.lastname: Gerber
authors.forename: Kateri H
authors.initials: KH
authors.lastname: Leckerman
authors.forename: Alix E
authors.initials: AE
authors.lastname: Seif
authors.forename: Yuan-Shung V
authors.initials: YS
authors.lastname: Huang
authors.forename: Yimei
authors.initials: Y
authors.lastname: Li
authors.forename: Tracey
authors.initials: T
authors.lastname: Harris
authors.forename: Kari
authors.initials: K
authors.lastname: Torp
authors.forename: Rheam
authors.initials: R
authors.lastname: Douglas
authors.forename: Ami
authors.initials: A
authors.lastname: Shah
authors.forename: Dana
authors.initials: D
authors.lastname: Walker
authors.forename: Richard
authors.initials: R
authors.lastname: Aplenc
mesh_terms: D000293:Adolescent; D000900:Anti-Bacterial Agents / Q000627:therapeutic use; D002648:Child; D002675:Child, Preschool; D011307:Drug Prescriptions / Q000706:statistics & numerical data*; D005260:Female; D006776:Hospitals, Pediatric; D006801:Humans; D008297:Male; D010818:Practice Patterns, Physicians' / Q000706:statistics & numerical data; D054198:Precursor Cell Lymphoblastic Leukemia-Lymphoma / Q000453:epidemiology*; D012189:Retrospective Studies; D014481:United States / Q000453:epidemiology
chemical_list: D000900:Anti-Bacterial Agents