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Adopting otitis media practice guidelines increases adherence within a large primary care network

Mikaela Bradley1, Ali Bacharouch2, Tamera Hart-Johnson3

  • 1University of Michigan College of Literature, Science, and the Arts, Ann Arbor, Michigan, United States.

Journal of Paediatrics and Child Health
|February 16, 2021
PubMed

Insights

Implementing clinical guidelines for otitis media (OM) significantly improved pediatric treatment adherence. This led to a notable decrease in unnecessary antibiotic prescriptions for children with OM, reducing risks and combating antibiotic resistance.

Area of Science:

  • Pediatrics
  • Infectious Diseases
  • Clinical Practice Guidelines

Background:

  • Unnecessary antibiotic prescriptions for otitis media (OM) contribute to adverse drug reactions, increased healthcare costs, and the growing problem of antibiotic resistance.
  • Clinical care guidelines are essential tools for promoting consistent and evidence-based treatment of common pediatric conditions like OM.

Purpose of the Study:

  • To evaluate the adherence to an institutional guideline for the diagnosis and treatment of pediatric otitis media (OM) before and after its implementation.
  • To assess the impact of the guideline on antibiotic prescribing patterns for pediatric OM.

Main Methods:

  • A retrospective chart review was conducted on pediatric patients diagnosed with OM within a primary care network.
  • Encounter data from 2013 (pre-guideline) and 2016 (post-guideline) were compared to analyze treatment adherence factors.

Main Results:

  • Overall adherence to the OM guideline increased significantly from 61.2% in 2013 to 70.6% in 2016 (P < 0.0017).
  • Antibiotic use for acute OM decreased from 99.7% to 96.7% (P = 0.0015).
  • Prescriptions for OM with effusion saw a significant reduction from 42.9% to 17.4% (P < 0.0006).

Conclusions:

  • Implementation of an institutional OM clinical practice guideline significantly improved treatment adherence in pediatric patients.
  • The guideline led to a significant decrease in antibiotic prescriptions for both acute OM and OM with effusion between 2013 and 2016.
Abstract

Keywords:
adherenceclinical care guidelineotitis media

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