- Design
- Interrupted time series follow-up of a site-randomised trial
- Population
- Children treated for skin and soft-tissue infections across a US statewide paediatric network
- Primary outcome
- Proportion of infections treated ≤7 days
- Effect
- 62.5% to 88.5%, sustained over 24 months
Following a site-randomised trial, a large US statewide paediatric network gave clinicians three months of performance feedback and education on shorter antibiotic courses for skin and soft-tissue infections, plus a permanent alert in the electronic record at the point of prescribing.
The proportion of infections treated for seven days or less rose from 62.5% to 88.5% and held there for the following 21 months after feedback ended, with no decline.
Stewardship gains often fade when a project stops. Here, a simple, durable prompt kept them. It is an uncontrolled before-and-after follow-up, but the size and persistence of the change are notable.
- Most uncomplicated skin and soft-tissue infections in children need five to seven days of antibiotics.
- Build duration defaults and alerts into prescribing systems rather than relying on one-off education.
- Drain abscesses — for simple abscesses, drainage matters more than antibiotic duration.
- Review the child at 48–72 hours rather than prescribing longer 'to be safe'.
Why it matters
It shows a cheap, lasting way to hold stewardship gains after the teaching stops.
The statistics, in plain English
A monthly slope of +0.2% after the active phase means performance held steady rather than drifting back.
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