Pediatric Antibiotic Prescribing and Utilization Practices for RTIs at Private Urgent Care Centers

Area of Science:

• Pediatric healthcare
• Infectious disease management
• Antibiotic stewardship

Background:

• Limited data exists on antibiotic prescribing practices in pediatric urgent care centers (UCC).
• Urgent care centers play a growing role in managing pediatric respiratory tract infections (RTIs).

Purpose of the Study:

• To compare antibiotic prescribing and guideline adherence for pediatric RTIs between UCCs staffed by pediatric specialists and those with mixed or non-pediatric staff.
• To identify differences in RTI diagnosis and management based on UCC staffing models.

Main Methods:

• Retrospective electronic medical record review of 457 pediatric RTI encounters at a mid-sized pediatric practice.
• Comparison of antibiotic prescribing and adherence to clinical guidelines between pediatric-staffed UCCs and non-pediatric-staffed UCCs.
• Analysis of common RTI diagnoses and adherence to specific management guidelines (e.g., streptococcal pharyngitis).

Main Results:

• 72% of all analyzed RTI visits occurred at the pediatric UCC.
• Guideline adherence for bacterial RTIs was significantly higher at the pediatric UCC (82%) compared to non-pediatric UCCs (59%, P < .001).
• Non-pediatric UCCs had lower adherence to streptococcal management guidelines (41%) and saw a higher proportion of older children (>10 years).

Conclusions:

• Pediatric-staffed UCCs demonstrate superior adherence to RTI treatment guidelines.
• Ambulatory antibiotic stewardship efforts should prioritize education for UCCs, particularly those not exclusively staffed by pediatric providers.
• Urgent care center staffing models may influence the appropriateness of pediatric RTI management.