Antibiotic Prescribing Patterns for Pediatric Urgent Care Clinicians.
Document Type
Article
Publication Date
9-1-2022
Identifier
DOI: 10.1097/PEC.0000000000002809
Abstract
OBJECTIVE: Previous studies have reported high rates of inappropriate antibiotic prescriptions in urgent care (UC). Specific prescribing patterns for the most common diagnoses are not known. The aim of the study is to determine the diagnoses for which antibiotics are prescribed in pediatric UC settings.
METHODS: We recruited pediatric UC providers via email to participate in a national multisite quality improvement study. Participants completed a survey on 10 consecutive encounters in which an antibiotic was given between March and May 2018. Encounters in which only topical antibiotics were prescribed were excluded. We categorized the encounters into 3 previously established tiers to determine appropriateness of antibiotic use. The tiers represent a descending order for antibiotic need based on diagnoses, with the first tier representing diagnoses almost always requiring antibiotics and the third tier representing diagnoses when an antibiotic is almost never required. We reported the diagnoses and frequency of antibiotic prescription within each tier.
RESULTS: The 157 providers from 20 institutions submitted a total of 2809 encounters. We excluded 339 encounters in which only topical antibiotics were prescribed. Most diagnoses fell into the tier 2 category (85.81%), with only 9.12% in tier 1 and 5.06% in tier 3. The most common diagnoses reported were acute otitis media (48.96%), pharyngitis (25.09%), and skin and soft tissue infections (7.29%).
CONCLUSIONS: In this sample of pediatric UC encounters, only 5% of diagnoses receiving antibiotic prescriptions were made up of tier 3 diagnoses, determined to almost never require antibiotics. While viral respiratory infections have been reported to frequently be treated with antibiotics in general UC centers, our study of pediatric UC centers showed that this was infrequent. However, otitis media with effusion and otalgia should be further investigated. With most antibiotic prescriptions being tier 2 diagnoses, pediatric UC providers can use evidence-based prescribing practices, shared decision making, and contingency plans to reduce unnecessary antibiotic exposure.
Journal Title
Pediatric emergency care
Volume
38
Issue
9
First Page
1538
Last Page
1540
MeSH Keywords
Ambulatory Care; Anti-Bacterial Agents; Child; Drug Prescriptions; Humans; Inappropriate Prescribing; Otitis Media; Practice Patterns, Physicians'; Respiratory Tract Infections
Keywords
Ambulatory Care; Anti-Bacterial Agents; Child; Drug Prescriptions; Humans; Inappropriate Prescribing; Otitis Media; Practice Patterns, Physicians'; Respiratory Tract Infections
Recommended Citation
Blanco MV, Hamdy RF, Liu CM, Jones H, Montalbano A, Nedved A. Antibiotic Prescribing Patterns for Pediatric Urgent Care Clinicians. Pediatr Emerg Care. 2022;38(9):e1538-e1540. doi:10.1097/PEC.0000000000002809
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