Overprescribing of Antibiotics for Children Cut By More Than 50% At Clinics By Using Techniques Widely Available: Study

Amid continuing concerns about the long-term effects of overprescribing antibiotics to children, which has resulted in the emergence of dangerous antibiotic resistant bacteria that is difficult to treat, the findings of a new study show that clinics employing a series of tactics were able to reduce antibiotic prescriptions for children by more than half.

When prescribed for some ailments, like pharyngitis or the common sore throat, the program helped to reduce inappropriate antibiotic prescribing by more than 55%, according to researchers from the Society of Pediatric Urgent Care. Their findings were published June 15, in the journal Pediatrics.

Researchers invited pediatric urgent care doctors to participate in a multisite quality improvement study from June 2019 to December 2019. Doctors from 20 urgent care centers were included and diagnosis for ailments like acute otitis media, otitis media with effusion, and pharyngitis were included in the study.

Acute otitis media is an ear infection, otitis media with effusion is water in the middle ear without an infection, and pharyngitis is inflammation of the throat, or the common sore throat; which can be a symptom for many ailments.

The researchers used an algorithm to identify inappropriate antibiotic prescriptions. Sites also completed multiple intervention cycles from a menu of publicly available antibiotic stewardship materials. A total of 157 doctors from 20 urgent care centers submitted data from 3,833 encounters during the intervention cycles.

Urgent care clinics have the highest rate of inappropriate antibiotic prescriptions out of all outpatient settings. In many cases, the urgent care clinics have lacked a documented reason for the antibiotic prescription, such as bacterial infection. In fact, antibiotics are still prescribed for no good reason 45% of the time.

This new study indicates inappropriate antibiotic prescription rates decreased by 54% overall after clinics employed doctor interventions to ensure proper prescribing. Inappropriate prescribing for acute otitis media decreased from 57% to 37%, prescribing for otitis media with effusion dropped from 55% to 48%, and prescribing for pharyngitis decreased from 67% to 12%.

Across the entire study, inappropriate antibiotic prescriptions were decreased from 60% to 29% using the publicly available interventions.

Other programs have successfully used tactics like doctor peer comparisons, doctor monitoring programs, and online training courses to help reduce inappropriate antibiotic prescribing among doctors in many settings, including urgent care clinics.

In addition to long-term concerns about difficult to treat “superbugs” that are resistant to available antibiotics, prior research has also shown overprescribing the drugs can increase a child’s risk of suffering inflammatory bowel disease later in life and suffering from Clostridium difficile infections.