Our goal is to develop prototype electronic health record-based clinical decision support that will facilitate the appropriate use of antibiotics for children with community-acquired pneumonia or urinary tract infections. The decision support will be scalable across multiple sites. Decision support models will be developed at 3 PECARN sites. Antimicrobial resistance results in patient morbidity and mortality, and increased healthcare costs and is a result of indiscriminate antibiotic prescribing by clinicians. Antimicrobial stewardship programs facilitate appropriate antibiotic prescribing. There is a gap in understanding the optimal strategies to implement ED-based antimicrobial stewardship programs.

After the development of the decision support, we will conduct a multicenter trial to test its effectiveness to decrease the inappropriate use of antibiotics for these t+N2wo common pediatric infections. If successful, we will conduct further antimicrobial stewardship trials to facilitate the proper use of antibiotics for other common pediatric infections in order to minimize antimicrobial resistance.