Rates of receipt of recommended antibiotic prophylaxis and annual transcranial Doppler low
By Elana Gotkine HealthDay Reporter
MONDAY, March 18, 2024 (HealthDay News) — A number of children with sickle cell anemia (SCA) have low rates of receipt of recommended antibiotic prophylaxis and annual transcranial Doppler (TCD) ultrasound, according to a study published online March 6 in Pediatrics.
Ashaunta T. Anderson, M.D., M.P.H., from the Keck School of Medicine at the University of Southern California, Los Angeles, and colleagues examined two quality measures in individuals with hemoglobin S/S or S/β-zero thalassemia using data from the Sickle Cell Data Collection programs in California and Georgia from 2010 to 2019. The proportion of patients aged 3 months to 5 years who were dispensed antibiotic prophylaxis for at least 300 days within each measurement year and the proportion of patients aged 2 to 15 years who received at least one TCD ultrasound within each measurement year were examined.
The researchers found that 22.2 and 15.5 percent of those in California and Georgia, respectively, met or exceeded the quality measure for antibiotic prophylaxis, with increased odds associated with rural versus urban residence in Georgia (odds ratio, 1.61; 95 percent confidence interval, 1.21 to 2.14) and a trend toward increased odds associated with a pediatric hematologist prescriber versus a general pediatrician (odds ratio, 1.28; 95 percent confidence interval, 0.97 to 1.69). Approximately half of the sample received an annual assessment of stroke risk using TCD (47.4 and 52.7 percent in California and Georgia, respectively); the odds were increased each additional year in both states and for younger children.
“Despite support from high-quality studies and explicit clinical guidelines, many children with SCA do not receive adequate antibiotic prophylaxis or annual screenings for stroke risk,” the authors write. “This may reflect gaps in provider knowledge and practice alongside challenges families face accessing care.”
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