# Standardization of Evaluation to Treatment of pediatric perianal Crohn’s disease and improving Outcomes through Networking (SETON)

> **NIH AHRQ R01** · UNIVERSITY OF MICHIGAN AT ANN ARBOR · 2024 · $393,216

## Abstract

ABSTRACT
Antibiotics are given universally to treat Crohn’s disease, especially with perianal fistulizing complications (PFC),
which occur in about 1/3 of children. Decreasing the utilization is challenging, yet significant, as many guidelines
support the use of antibiotics as first-line despite a lack of research showing benefit. Furthermore, there is such
variation in treatment not only regarding antibiotic use but also around use of other medications, interventions
such as drainage, and timing of each of these. In this innovative proposal, the investigators evaluate the current
practices for management of PFC in Crohn’s disease at seven large pediatric institutions, develop a protocol to
guide antibiotic stewardship, and improve care through a multidisciplinary approach (pediatric gastroenterology,
surgery, infectious disease, radiology, and nursing) and prospective implementation arm for data collection and
evaluation of barriers and facilitators. Our central hypothesis is that antibiotic use for PFC in Crohn’s disease
can be reduced, and outcomes improved through standardization of multidisciplinary care of children. The
rationale for this project is that reduction in antibiotic use and providing higher quality care will reduce the risk of
developing healthcare-associated infections such as clostridioides difficile, acquiring resistant organisms, and
improved care will also reduce the risk of perianal abscess development or fistula recurrence among pediatric
patients with Crohn’s disease. We will test our hypothesis through the specific aims: 1) describe variation in
antibiotic use and treatment of PFCs among pediatric patients with Crohn’s disease at seven children’s hospitals;
2) develop evidence-based protocols through multidisciplinary, multicenter collaboration aimed at antibiotic
reduction and standardization of PFC care; and 3) implement the protocols for antibiotic stewardship and
prospectively evaluate the barriers and facilitators with shared insight of best practices for pediatric Crohn’s
disease. This approach will create an evidence-base for antibiotic utilization while standardizing the care for
pediatric Crohn’s disease at several institutions with prospective evaluation of outcomes. The proposed research
is innovative because it brings together multidisciplinary teams from multiple institutions to develop a shared
approach to improving care, that is currently not standardized, or evidence-based. The proposed study is
significant because it has the potential to change the paradigm for pediatric multidisciplinary care of complex
conditions beyond pediatric Crohn’s disease.

## Key facts

- **NIH application ID:** 10831409
- **Project number:** 5R01HS029313-02
- **Recipient organization:** UNIVERSITY OF MICHIGAN AT ANN ARBOR
- **Principal Investigator:** Jeremy Adler
- **Activity code:** R01 (R01, R21, SBIR, etc.)
- **Funding institute:** AHRQ
- **Fiscal year:** 2024
- **Award amount:** $393,216
- **Award type:** 5
- **Project period:** 2023-06-01 → 2028-04-30

## Primary source

NIH RePORTER: https://reporter.nih.gov/project-details/10831409

## Citation

> US National Institutes of Health, RePORTER application 10831409, Standardization of Evaluation to Treatment of pediatric perianal Crohn’s disease and improving Outcomes through Networking (SETON) (5R01HS029313-02). Retrieved via AI Analytics 2026-05-24 from https://api.ai-analytics.org/grant/nih/10831409. Licensed CC0.

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