Study: Antibiotic Prescriptions Decreased 7% in Quality Improvement Intervention

Antibiotics are overprescribed in children, with an estimated one-third of all outpatient prescriptions for pediatric acute respiratory tract infections considered inappropriate. In the September 2020 Pediatrics, a study looks at the success of a quality improvement intervention that resulted in a 7% sustained reduction in the probability of antibiotic prescribing for acute respiratory tract infections. The study, “Reducing Antibiotic Prescribing in Primary Care for Respiratory Illness,” published online Aug. 3, reviewed the impact of an intervention that combined communication training, evidence-based education on antibiotic prescribing, and individualized clinician prescribing feedback. Researchers enrolled 57 clinicians at 19 practices from November 2015 through June 2018, and reviewed visits for acute otitis media, bronchitis, pharyngitis, sinusitis, and upper respiratory infection for children 6 months to 11 years old. In total, they analyzed 72,723 visits by 29,762 patients across nine states. The decrease in overall rate of antibiotic prescribing occurred among all visits for acute respiratory tract infections, and this effect was sustained in the 2- to 8-month post-intervention period. The intervention did not, however, result in sustained reductions in antibiotic prescribing during all pharyngitis visits, nor in reduced second-line antibiotic prescribing for acute otitis media. Researchers conclude the intervention could be beneficial as a way to reduce the more than 10 million antibiotics unnecessarily prescribed to children each year, which contribute to increased antibiotic resistance and adverse drug effects.

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The American Academy of Pediatrics is an organization of 67,000 primary care pediatricians, pediatric medical subspecialists and pediatric surgical specialists dedicated to the health, safety and well-being of infants, children, adolescents and young adults.