UF Health Pediatric Antibiotic Stewardship Project
Overview
In this PCORI-funded project, UF Health will put in place a program to improve antibiotic prescribing for children with acute respiratory tract infections (ARTIs) in outpatient settings in two states, drawing on findings from PCORI-funded research comparing the use of broad-spectrum and narrow-spectrum antibiotics in this population.
About the Project
Through the PCORI Health Systems Implementation Initiative (HSII), participating health systems lead projects to promote the uptake of specific PCORI-funded comparative clinical effectiveness research (CER) evidence that has demonstrated success in enhancing patient-centered clinical outcomes across a range of care delivery settings.
In this project, University of Florida Health will put in place a program to improve antibiotic prescribing for children with acute respiratory tract infections (ARTIs) in outpatient settings in two states, drawing on findings from PCORI-funded research comparing the use of broad-spectrum and narrow-spectrum antibiotics in this population.
26 Sites Participating Care Delivery sites will include 26 UF Health and UF Health – Jacksonville outpatient clinics that provide pediatric primary and emergency care located in Gainesville, Ocala, and Jacksonville areas.
24,000 children We intend to reach 24,000 unique children aged 6 months to 12 years treated for ARTIs over the 18-month implementation period.
Implementation Strategies
Clinical Decision Support Tools
Includes Epic SmartSets and Express Lanes that are automatically available for ARTI-related chief complaints, treatment recommendations, first-line antibiotic orders, patient education.
CDS tools also includes embedded alerts that trigger based on ARTI diagnosis and non-recommended antibiotic; displays recommendations for first-line treatment
Audit & Feedback
Individual clinicians will receive monthly personalized audit and feedback reports upon activation of the SmartSets/Express Lanes in their clinic. Clinicians will receive reports through the 18-month implementation phase.
Practice Facilitation
Dedicated Practice Facilitators will support implementation efforts at the Gainesville, Ocala, and Jacksonville clinics by providing technical assistance and helping to adapt clinical processes.
Training & Education
Clinician training and education on SmartSets/Express Lanes and appropriate antibiotic use will be delivered in-person and online.
Patients and families will receive education on appropriate use of antibiotics. Educational handouts for patients and families (English and Spanish) will be provided to clinics and integrated in the EHR for use in after-visit summaries.
Clinician Education & Resources
clinician resource
Clinical Pathway Protocols
The Clinical Pathway Protocols developed for the ARTI project served as the foundation for the Clinical Decision Support tools developed in Epic. The pathways were reviewed and approved by the UF Shands’ Antimicrobial Stewardship Committee and can be found on the Antimicrobial Management Program’s UF Health Bridge website (requires UFH VPN login). Individual links are provided below:
clinician training and education
Pediatric Grand Rounds Presentations
The main takeaway of this teaching session is that appropriate antibiotic prescribing for pediatric ARTIs is critical to reducing unnecessary broad-spectrum use and preventing antibiotic resistance. Clinicians will learn best practice guidelines and become familiar with EHR tools that support consistent, evidence-based decision making to maximize prescribing success. The ultimate goal is to optimize antibiotic selection for pediatric ARTIs while ensuring safe, effective, and high-value care.
- UF Health Gainesville Grand Rounds Recording – 10/9/2025 (requires UFH VPN login)
- Grand Rounds Presentation Slide Deck
Demo Videos: SmartSets & Express Lanes
DEMO – SMARTSETs & EXPRESS LANES
Test Case One: 7yo with chief complaint of fever
- Chief Complaint (CC): Fever
- History of Present Illness (HPI): Previously healthy 7-year-old female presents to the clinic with a fever up to 39°C for the past two days. She also has a one-day history of severe left ear pain that is significant enough to interfere with her sleep, and her symptoms have kept her out of school. She had a runny nose and cough earlier this week, but they have both improved.
- Past Medical History (PMHx): 1-2 ear infections as a toddler, but has not had additional infections, ear or other, in the past 2 years requiring antibiotics.
- Allergies: No Known Drug Allergies (NKDA)
Demo Video:
demo – smartsets & express lanes
Test Case Two: 11yo with chief complaint of cough and ear pain
- CC: Cough and Ear Pain
- HPI: Previously healthy 11-year-old male who presents to the clinic today with worsening cough and new onset right ear pain over the past two days, but no problems with his breathing. Of note, his sister had similar symptoms last week and was diagnosed with Influenza A. He had a runny nose and body aches earlier this week, but both symptoms have improved.
- PMHx: 1-2 ear infections as a toddler, but has not had additional infections, ear or other, in the past 2 years requiring any antibiotics.
- Allergies: NKDA
Demo Video:
project contact information
Questions?
For questions about the UF Health Pediatric Antibiotic Stewardship project, please contact Jennifer LeLaurin, PhD, and Jacqueline De La Cruz, MPH.