Original Article Optimizing Care With a Standardized Management Protocol for Patients With Infantile Spasms

The primary aim of this quality improvement initiative was to increase the number of patients receiving first-line therapy (adrenocorticotropic hormone, corticosteroids, vigabatrin) as the initial treatment for infantile spasms. We implemented a standardized management protocol for infantile spasms based on the best available data and expert consensus. To assess the impact of this intervention, we compared the 3-month remission rates between prestandardization (January 2009 to August 2012) and poststandardization (September 2012 to May 2014) cohorts. We found that the percentage of patients receiving first-line therapy as the initial treatment was 57 % (31/54) in the prestandardization cohort and 100 % (35/35) in the poststan-dardization cohort (P <.001). The rate of infantile spasms remission was higher poststandardization compared to prestandar-dization (78.8 % vs 30.6%, P <.001). Management standardization led to all patients receiving first-line therapy as the initial treatment and was associated with a significantly improved rate of infantile spasms remission 3 months after diagnosis