BACKGROUND Variability exists in treatment duration for community-acquired pneumonia (CAP) and urinary tract infection (UTI) in children and may be associated with non-clinical factors. METHODS A retrospective study was conducted of patients treated for outpatient CAP and UTI in a children's hospital network from 2016 to 2019. Multivariable logistic regression was performed to identify predictors of long antibiotic duration (≥10 days). Hospitalization within 30 days was determined. RESULTS Overall, 2124 prescriptions for CAP and 1116 prescriptions for UTI were included. Prescriptions were ≥10 days in 59.9% and 47.6% for CAP and UTI, respectively. Long durations were more common in the emergency department (ED) than in clinics for UTI's (P = .0082), and more common in convenient care for CAP (P = .045). In UTI's, Asian and Hispanic patients received shorter durations than white patients. Younger children had greater odds of long duration for both diagnoses. Medicaid insurance was associated with long therapy for UTI (OR: 1.660, P = .0042) and CAP (OR: 1.426, P = .0169). Residents and fellows were less likely to give long durations than attending physicians (P < .0001). APNs were more likely to administer long therapies in CAP (P = .0062). Subsequent hospitalizations were uncommon for UTI (n = 10) and CAP (n = 20). CONCLUSIONS Younger age, Medicaid insurance, ED, and convenient care visits were associated with a long duration of therapy. Residents and fellows were less likely to give long durations.

中文翻译：

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尿路感染和社区获得性肺炎长期门诊抗生素治疗的驱动因素。

背景 儿童社区获得性肺炎 (CAP) 和尿路感染 (UTI) 的治疗持续时间存在差异，并且可能与非临床因素有关。方法 对 2016 年至 2019 年在儿童医院网络中接受门诊 CAP 和 UTI 治疗的患者进行回顾性研究。进行多变量逻辑回归以确定长抗生素持续时间（≥10 天）的预测因子。确定在 30 天内住院。结果 总体而言，包括 2124 份 CAP 处方和 1116 份 UTI 处方。对于 CAP 和 UTI，分别有 59.9% 和 47.6% 的处方≥10 天。UTI 的持续时间长在急诊科 (ED) 比在诊所更常见 (P = .0082)，并且在 CAP 的便利护理中更常见 (P = .045)。在 UTI 中，亚裔和西班牙裔患者接受的持续时间比白人患者短。年幼的孩子在这两种诊断中持续时间更长的可能性更大。医疗补助保险与 UTI (OR: 1.660, P = .0042) 和 CAP (OR: 1.426, P = .0169) 的长期治疗相关。与主治医师相比，住院医师和研究员不太可能延长治疗时间 (P < .0001)。APNs 更有可能在 CAP 中进行长期治疗 (P = .0062)。UTI (n = 10) 和 CAP (n = 20) 的后续住院并不常见。结论 较年轻、医疗补助保险、急诊和方便的就诊与较长的治疗时间相关。居民和研究员不太可能给予长时间。医疗补助保险与 UTI (OR: 1.660, P = .0042) 和 CAP (OR: 1.426, P = .0169) 的长期治疗相关。与主治医师相比，住院医师和研究员不太可能延长治疗时间 (P < .0001)。APNs 更有可能在 CAP 中进行长期治疗 (P = .0062)。UTI (n = 10) 和 CAP (n = 20) 的后续住院并不常见。结论 较年轻、医疗补助保险、急诊和方便的就诊与较长的治疗时间相关。居民和研究员不太可能给予长时间。医疗补助保险与 UTI (OR: 1.660, P = .0042) 和 CAP (OR: 1.426, P = .0169) 的长期治疗相关。与主治医师相比，住院医师和研究员不太可能延长治疗时间 (P < .0001)。APNs 更有可能在 CAP 中进行长期治疗 (P = .0062)。UTI (n = 10) 和 CAP (n = 20) 的后续住院并不常见。结论 较年轻、医疗补助保险、急诊和方便的就诊与较长的治疗时间相关。居民和研究员不太可能给予长时间。UTI (n = 10) 和 CAP (n = 20) 的后续住院并不常见。结论 较年轻、医疗补助保险、急诊和方便的就诊与较长的治疗时间相关。居民和研究员不太可能给予长时间。UTI (n = 10) 和 CAP (n = 20) 的后续住院并不常见。结论 较年轻、医疗补助保险、急诊和方便的就诊与较长的治疗时间相关。居民和研究员不太可能给予长时间。