Evidence map›Paper›PMID 39623533›Full record

ArticleInfection control and hospital epidemiology2025

Sociodemographic differences in treatment of acute respiratory infections in pediatric urgent cares.

Rana E El Feghaly, Luis E Sainz, Brian R Lee, Matthew P Kronman, Adam L Hersh, Victoria Parente, Destani Bizune, Guillermo V Sanchez, Rana F Hamdy, Amanda Nedved and 1 more

Abstract readMulticenter Study
In one paragraph

Article in Infection control and hospital epidemiology, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 2 papers.

0numbers the graph read from it
0cells of the map it votes in
2citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

2 citing papers in PubMed.

  1. Article
  2. Article
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

11 authors.

Rana E El FeghalyDepartment of Pediatrics, Children's Mercy Kansas City, Kansas City, MO, USA.ORCID https://orcid.org/0000-0001-7533-1144
Luis E SainzDepartment of Pediatrics, Children's Mercy Kansas City, Kansas City, MO, USA.
Brian R LeeDepartment of Pediatrics, Children's Mercy Kansas City, Kansas City, MO, USA.ORCID https://orcid.org/0000-0002-1337-1105
Matthew P KronmanDepartment of Pediatrics, University of Washington School of Medicine, Seattle Children's Hospital, Seattle, WA, USA.ORCID https://orcid.org/0000-0002-1856-6841
Adam L HershDivision of Infectious Diseases, Department of Pediatrics, University of Utah, Salt Lake City, UT, USA.ORCID https://orcid.org/0000-0002-0148-046X
Victoria ParenteDepartment of Pediatrics, Duke University School of Medicine, Durham, NC, USA.ORCID https://orcid.org/0000-0002-0112-537X
Destani BizuneDivision of Healthcare Quality Promotion, Centers for Disease Control and Prevention, Atlanta, GA, USA.ORCID https://orcid.org/0000-0002-4003-039X
Guillermo V SanchezDivision of Healthcare Quality Promotion, Centers for Disease Control and Prevention, Atlanta, GA, USA.
Rana F HamdyDivision of Infectious Diseases, Children's National Hospital, Washington, DC, USA.ORCID https://orcid.org/0000-0002-7536-3020
Amanda NedvedDepartment of Pediatrics, Children's Mercy Kansas City, Kansas City, MO, USA.ORCID https://orcid.org/0000-0002-5564-3762
For REDUCE (Reducing Differences in Urgent Care Encounters – Antibiotic Choice) Collaborative

Funding

Intramural CDC HHS CC999999
6 · The paper itself

Abstract

objectiveTo determine whether differences exist in antibiotic prescribing for respiratory infections in pediatric urgent cares (PUCs) by patient race/ethnicity, insurance, and language.

designMulti-center cohort study.

settingNine organizations (92 locations) from 22 states and Washington, DC.

participantsPatients ages 6 months-18 years evaluated April 2022-April 2023, with acute viral respiratory infections, otitis media with effusion (OME), acute otitis media (AOM), pharyngitis, community-acquired pneumonia (CAP), and sinusitis.

methodsWe compared the use of first-line (FL) therapy as defined by published guidelines. We used race/ethnicity, insurance, and language as exposures. Multivariable logistic regression models estimated the odds of FL therapy by group.

resultsWe evaluated 396,340 ARI encounters. Among all encounters, 351,930 (88.8%) received FL therapy (98% for viral respiratory infections, 85.4% for AOM, 96.0% for streptococcal pharyngitis, 83.6% for sinusitis). OME and CAP had the lowest rates of FL therapy (49.9% and 60.7%, respectively). Adjusted odds of receiving FL therapy were higher in Black Non-Hispanic (NH) (adjusted odds ratio [aOR] 1.53 [1.47, 1.59]), Asian NH (aOR 1.46 [1.40, 1.53], and Hispanic children (aOR 1.37 [1.33, 1.41]), compared to White NH. Additionally, odds of receiving FL therapy were higher in children with Medicaid/Medicare (aOR 1.21 [1.18-1.24]) and self-pay (aOR 1.18 [1.1-1.27]) compared to those with commercial insurance.

conclusionsThis multicenter collaborative showed lower rates of FL therapy for children of the White NH race and those with commercial insurance compared to other groups. Exploring these differences through a health equity lens is important for developing mitigating strategies.

Indexed as

Ambulatory CareAnti-Bacterial AgentsHealthcare DisparitiesPractice Patterns, Physicians'Respiratory Tract InfectionsAcute DiseaseAdolescentChildChild, PreschoolCohort StudiesFemaleHumansInfantInsurance, HealthLogistic ModelsMaleAnti-Bacterial Agents

Identifiers

PMID39623533
PMCPMC13244395

What Socratic holds

Textmetadata
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Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the Socratic graph.