WIP 24 - Examining the Influence of Race, Ethnicity, and Language on Antibiotic Timeliness in a Pediatric ED

Publication Number: WIP 24.7376

Johnathone Yang, University of Minnesota, Minneapolis, MN, United States; Laura Norton, University of Minnesota Masonic Children's Hospital, Minneapolis, MN, United States; Viviane Tchonang Leuche, University of Minnesota Masonic Children's Hospital, Minneapolis, MN, United States; Nasreen Quadri, HealthPartners, Minneapolis, MN, United States; Amy Kodet, University of Minnesota Medical School, Minneapolis, MN, United States; Benjamin Langworthy, University of Minnesota, Minneapolis, MN, United States; Meredith B.. Oliver, Boehringer Ingelheim, Minneapolis, MN, United States; Emily Lekah, Mayo Clinic Department of Pharmacy RST, Rochester, MN, United States

Background: Race, ethnicity and language preference for pediatric patients and their caregivers are key demographics to identify and mitigate inequities in healthcare outcomes. Higher rates of hospital adverse events are reported for patients with Limited English Proficiency (LEP) and higher sepsis mortality rates are reported for certain racial groups. However, there is a paucity of literature on the impact of race, ethnicity and language preference on timely management of sepsis and serious bacterial infections.

Objective: To assess whether time to antibiotic initiation for pediatric patients with suspected sepsis or serious bacterial infections in the emergency department differ among race, ethnicity, country of birth or language preference groups.

Design/Methods: This study received exempt determination from University of Minnesota Institutional Review Board. Data comprise pediatric patients seen at Masonic Children's Emergency Department during the study period from January 1, 2015 to December 31, 2023. Inclusion criteria: 1) age < 22 years and 2) administration of one of the following antibiotics: ceftazidime, ceftriaxone, cefepime, gentamicin, meropenem, piperacillin-tazobactam or vancomycin. Self-identified patient demographics include race, ethnicity, language preference, interpreter need and country of birth. Time to antibiotic initiation is determined by the time difference between ED arrival and first dose of antibiotic administration. Regression analysis will be completed for time to antibiotic initiation as the primary outcome with attention to the following predictors of interest: race, ethnicity, country of birth, language preference, interpreter need and insurance status. The model will be adjusted for confounding factors including age, sex, emergency severity index triage level, ICD10 diagnosis codes, and measures of socioeconomic status.

Results of this study will inform strategies to mitigate disparities in timely management of suspected serious bacterial infection in pediatric patients.