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Effect of educational intervention on antibiotic prescription practices for upper respiratory infections in children:
Yaron Razon1, Shai Ashkenazi, Avner Cohen
1Pediatric Infectious Disease Unit, Schneider Children's Medical Center of Israel, Petah Tiqva 49202, Israel. yaronraz@clalit.org.il
Insights
An educational intervention improved antibiotic prescribing for pediatric respiratory infections, increasing appropriate treatment for acute otitis media and pharyngitis. This approach successfully reduced unnecessary antibiotic use in children.
Area of Science:
- Pediatric infectious diseases
- Antibiotic stewardship
- Public health interventions
Background:
- Antibiotic resistance is a growing global health concern.
- Inappropriate antibiotic prescribing for pediatric respiratory infections contributes to resistance.
- Judicious antibiotic use is crucial for effective treatment and resistance mitigation.
Purpose of the Study:
- To assess the effectiveness of an educational intervention on pediatric antibiotic prescribing for upper respiratory diseases.
- To evaluate changes in the rates and appropriateness of antibiotic prescriptions following the intervention.
Main Methods:
- A multicenter before-and-after study was conducted in Israeli child health centers.
- Data on antibiotic prescriptions for acute otitis media, tonsillopharyngitis, sinusitis, and upper respiratory tract infections were collected.
- An educational seminar based on CDC guidelines was delivered to pediatricians.
Main Results:
- Appropriate antibiotic treatment odds ratios increased by 1.8 for acute otitis media and 1.35 for pharyngitis post-intervention.
- Overall antibiotic use decreased for acute otitis media (93% to 87.4%) and upper respiratory tract infections (13.8% to 11.5%).
- No significant changes were observed for sinusitis antibiotic prescribing patterns.
Conclusions:
- Targeted educational interventions can significantly improve antibiotic prescribing practices in pediatric care.
- Such interventions effectively reduce unnecessary antibiotic consumption for common childhood infections.
- Continuous monitoring and targeted education are vital for optimizing antibiotic stewardship.
Objectives:
To evaluate the impact of an educational intervention on judicious antibiotic prescription for upper respiratory diseases in children.
Methods:
A multicentre before-and-after study was conducted in five major community child healthcentres in Israel. Antibiotic prescription data were collected for all visits of patients aged 3 months to 18 years with a diagnosis of acute otitis media, tonsillopharyngitis, sinusitis or upper respiratory tract infection from November 1999 through February 2000 (pre-intervention period) and from November 2000 through February 2001 (post-intervention period). The intervention consisted of a 1 day seminar on the diagnosis and judicious treatment of respiratory tract infections in children according to the recommendations of the Centers of Disease Control and Prevention. The patient files were reviewed for patient characteristics, specific respiratory disease, and specific antibiotics prescribed. The main outcome measures were the rates and appropriateness of antibiotic prescribing for the different respiratory diseases before and after an educational intervention for practising paediatricians.
Results:
A total of 4580 clinic visits were eligible for analysis in the pre-intervention period and 4364 in the post-intervention period. From the pre- to the post-intervention period, the odds ratio for appropriate antibiotic treatment was 1.8 for acute otitis media (95% CI 1.52-2.11, P < 0.01) and 1.35 for pharyngitis (95% CI 1.13-1.61, P < 0.01). Overall, use of antibiotics for acute otitis media decreased from 93% to 87.4% (P < 0.05), and for upper respiratory tract infection, from 13.8% to 11.5% (P < 0.05). There were no significant changes in these factors for sinusitis.
Conclusions:
A targeted educational intervention can improve antibiotic prescription practices for respiratory infections in children and decrease unnecessary antibiotic use. Such studies can also pinpoint areas that require further attention.
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