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Multiplex Therapeutic Drug Monitoring by Isotope-dilution HPLC-MS/MS of Antibiotics in Critical Illnesses
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Decline in inappropriate antibiotic use over a decade by pediatricians in a Tennessee community

Sandra R Arnold1, Andrew J Bush

  • 1Department of Pediatrics, Division of Infectious Diseases, University of Tennessee Health Science Center, Memphis, TN 38103, USA. sarnold5@utmem.edu

Ambulatory Pediatrics : the Official Journal of the Ambulatory Pediatric Association
|July 18, 2006
PubMed

Insights

Inappropriate antibiotic prescribing for pediatric respiratory infections significantly decreased in Memphis, Tennessee, from 1992 to 2002. Pediatricians shifted to broader-spectrum antibiotics, highlighting the need for ongoing physician education on appropriate antibiotic use.

Area of Science:

  • Pediatric Infectious Diseases
  • Antimicrobial Stewardship
  • Public Health

Background:

  • Published data shows a national decline in antibiotic use for pediatric respiratory tract infections.
  • This study investigates antibiotic prescribing trends in two pediatric practices in Memphis, Tennessee.
  • The research aims to determine if inappropriate antibiotic use has decreased regionally.

Purpose of the Study:

  • To evaluate changes in inappropriate antibiotic prescribing for pediatric respiratory tract infections.
  • To assess the impact of a decade of antibiotic stewardship initiatives in a specific region.
  • To identify shifts in antibiotic classes used for pediatric respiratory infections.

Main Methods:

  • A retrospective chart review of 1504 pediatric visits for respiratory tract infections between 1992 and 2002.
  • Visits were from 7 offices across 2 pediatric practices, with data collected in alternate years.
  • Generalized estimating equations were used to analyze changes in inappropriate prescribing over time.

Main Results:

  • Antibiotic prescriptions decreased from 85% in 1992 to 67% in 2002.
  • Inappropriate antibiotic prescribing declined significantly (OR 0.28; 95% CI 0.20-0.38).
  • Use of amoxicillin-clavulanic acid and azithromycin increased, while amoxicillin use decreased.

Conclusions:

  • A substantial reduction in inappropriate antibiotic use was observed in Memphis pediatric practices.
  • Pediatricians increasingly prescribed broad-spectrum antibiotics for respiratory tract infections.
  • Continued physician education is crucial for maintaining and improving appropriate antibiotic prescribing practices.
Abstract

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