Paediatric anaesthesia & critical care
Diagnostic Stewardship of Respiratory Cultures Using Clinical Decision Support in the PICU
Authors' conclusion
In this multicenter cohort study, diagnostic stewardship of EACs using clinical decision support led by multidisciplinary teams was associated with reduced EAC use in the PICU without safety concerns.
Study context
- Population
- Pediatric Intensive Care Units (PICUs) across the US in the BrighT STAR Quality Improvement (QI) Collaborative, 2019–202315 sites
- Exposure
- Postimplementation vs preimplementation of diagnostic stewardship of endotracheal aspirate culture (EACs) using clinical decision support
- Outcome
- Monthly rate of EACs per 100 ventilator-days
Methodological detailsmulticenter, quality improvement collaborative, adjustment for seasonality
- Multicenter
- Quality improvement collaborative
- Adjustment for seasonality
Main finding
Mean monthly EAC rate
Relative rate
0.84
95% CI 0.78–0.90
By group
As reported in the abstract
Observational data: associations, not effects.
Secondary outcomes
| Outcome | RR (95% CI) | |
|---|---|---|
| Antibiotic initiations ratePostimplementation vs Preimplementation · remained stable | 0.98 (0.89–1.08) | |
| Antibiotic days of therapy ratePostimplementation vs Preimplementation · remained stable | 1.03 (0.95–1.11) | |
| 0.512Relative risk (log scale) |
Bronchoalveolar lavage cultures, PICU LOS, PICU or hospital readmissions, ventilation duration, ventilator-free days
- No significant changes
Safety
Sepsis and septic shock
- No significant changes in rates
Parts of this Brief are withheld: the automatic checks could not confirm them against the abstract.
Original publication
Diagnostic Stewardship of Respiratory Cultures Using Clinical Decision Support in the PICU. JAMA Netw Open. Published 1 July 2026. doi:10.
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