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Trans-Tympanic Drug Delivery for the Treatment of Ototoxicity

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Improving Delayed Antibiotic Prescribing for Acute Otitis Media.

Holly M Frost^1,2,3, Jennifer D Monti⁴, Leisha M Andersen⁵

¹Department of Pediatrics, Denver Health Medical Center, Denver, Colorado; holly.frost@dhha.org.

|May 13, 2021

Summary

A low-cost antimicrobial stewardship intervention significantly increased delayed antibiotic prescribing for acute otitis media in children. This approach sustained higher rates of delayed prescribing, reducing unnecessary antibiotic use across diverse pediatric practices.

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Published on: August 30, 2018

Area of Science:

Pediatrics
Antimicrobial Stewardship
Public Health

Background:

Acute otitis media (AOM) is a leading cause of antibiotic prescriptions in children.
Delayed antibiotic prescribing for AOM is a recommended strategy to reduce unnecessary antibiotic use.
Improving delayed prescribing practices is crucial for antimicrobial stewardship.

Purpose of the Study:

To implement and evaluate a low-cost antimicrobial stewardship intervention to increase delayed antibiotic prescribing for AOM.
To assess the sustainability of increased delayed prescribing rates post-intervention.

Main Methods:

A 6-month collaborative initiative involving education, audit, feedback, and online resources was implemented across 8 pediatric practices.
The Model for Improvement and plan-do-study-act cycles were utilized to drive practice change.
Generalized estimating equations analyzed delayed prescribing rates at baseline, intervention end, and 3- and 6-months postintervention.

Main Results:

The rate of delayed antibiotic prescribing increased from 2% at baseline to 21% at the intervention end.
Sustained significant increases in delayed prescribing were observed at 3 months (RRR: 8.46) and 6 months (RRR: 6.69) postintervention.
The intervention was effective across practices of varying sizes and settings.

Conclusions:

A low-cost, multi-faceted intervention can significantly and sustainably increase delayed antibiotic prescribing for AOM.
This strategy effectively reduces unnecessary antibiotic use in pediatric outpatient settings.
The intervention's success across diverse practice settings highlights its scalability.