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Outpatient antibiotic prescribing patterns in pediatric academic and community practices

      Highlights

      • Less antibiotic guideline compliance seen in the community versus academic setting.
      • Antibiotics given frequently for pharyngitis without positive test results.
      • Sinusitis and otitis media are overdiagnosed, and azithromycin overused.
      • Errors in antibiotic choice, dose, frequency, and duration frequently seen.
      Little is known about antibiotic prescribing differences between academic and community outpatient settings. This retrospective, cross-sectional chart review compares compliance with Infectious Diseases Society of America and American Academy of Pediatrics prescribing guidelines for otitis media, sinusitis, and pharyngitis in academic and affiliated community practices. The study results for correct antibiotic prescribing rate in the academic setting (67%) compared with the community setting (21%) demonstrate the urgent need for stewardship in community outpatient clinics.

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      References

        • Fleming-Dutra KE
        • Hersh AL
        • Shapiro DJ
        • Gaglani M
        • Murthy K
        • Zimmerman R
        • et al.
        Prevalence of inappropriate antibiotic prescriptions among US ambulatory care visits, 2010-2011.
        JAMA. 2016; 315: 1864-1873
        • Barlam TF
        • Morgan JR
        • Wetzler LM
        • Christiansen CL
        • Drainoni ML
        Antibiotics for respiratory tract infections: a comparison of prescribing in an outpatient setting.
        Infect Control Hosp Epidemiol. 2015; 36: 153-159
        • Gerber JS
        • Prasad PA
        • Russell Localio A
        • Fiks AG
        • Grundmeier RW
        • Bell LM
        • et al.
        Variation in antibiotic prescribing across a pediatric primary care network.
        J Pediatric Infect Dis Soc. 2015; 4: 297-304
        • Sanchez GV
        • Fleming-Dutra KE
        • Roberts RM
        • Hicks LA
        Core elements of outpatient antibiotic stewardship.
        MMWR. 2016; 65: 1-12
        • Gerber JS
        • Ross RK
        • Bryan M
        • Localio AR
        • Szymczak JE
        • Wasserman R
        • et al.
        Association of broad- vs narrow-spectrum antibiotics with treatment failure, adverse events, and quality of life in children with acute respiratory tract infections.
        JAMA. 2017; 318: 2325-2336
        • Parente DM
        • Timbrook TT
        • Caffrey AR
        • LaPlante KL
        Inappropriate prescribing in outpatient healthcare: an evaluation of respiratory infection visits among veterans in teaching versus non-teaching primary care clinics.
        Antimicrob Resist Infect Control. 2017; 6: 33
        • Chow AW
        • Benninger MS
        • Brook I
        • Brozek JL
        • Goldstein EJ
        • Hicks LA
        • et al.
        IDSA clinical practice guideline for acute bacterial rhinosinusitis in children and adults.
        Clin Infect Dis. 2012; 54: e72-112
        • Wald E
        • Applegate KE
        • Bordley C
        • Darrow DH
        • Glode MP
        • Marcy SM
        • et al.
        Clinical practice guideline for the diagnosis and management of acute bacterial sinusitis in children aged 1 to 18 years.
        Pediatrics. 2013; 132: e262-e280
        • Lieberthal AS
        • Carroll AE
        • Chonmaitree T
        • Ganiats TG
        • Hoberman A
        • Jackson MA
        • et al.
        The diagnosis and management of acute otitis media.
        Pediatrics. 2013; 131: e964-e999
        • Shulman S
        • Bisno AL
        • Clegg HG
        • Gerber MA
        • Kaplan EL
        • Lee G
        • et al.
        Clinical practice guideline for the diagnosis and management of group A streptococcal pharyngitis: 2012 update by the Infectious Diseases Society of America.
        Clin Infect Dis. 2012; 55: e86-102