Antibiotic Stewardship for Community-Acquired Pediatric Pharyngitis: A Pre-Post Intervention Study

Area of Science:

• Pediatrics
• Infectious Diseases
• Public Health

Background:

• Group A Streptococcus (GAS) pharyngitis is a common bacterial infection in children, often clinically indistinguishable from viral pharyngitis.
• Antibiotic overuse is prevalent in pediatric pharyngitis, despite a high incidence of viral infections.

Purpose of the Study:

• To evaluate the impact of an antibiotic stewardship program (ASP) on antibiotic prescribing practices for pediatric GAS pharyngitis.
• To assess changes in diagnostic testing and antibiotic selection following the ASP intervention.

Main Methods:

• A quasi-experimental design comparing antibiotic prescription data from pre-intervention (2016-2017) and post-intervention (2017-2018) periods.
• The intervention involved a one-day educational seminar for pediatricians on GAS pharyngitis diagnosis and treatment guidelines.

Main Results:

• A decrease in the percentage of children receiving no laboratory testing for GAS pharyngitis (68% to 63%).
• An increase in rapid antigen detection testing (28% to 32%) and throat cultures (3% to 4%).
• No significant change in the types of antibiotics prescribed, including broad-spectrum agents and macrolides.

Conclusions:

• The ASP led to a modest improvement in diagnostic testing for GAS pharyngitis.
• The program achieved a slight reduction in overall antibiotic prescriptions for GAS pharyngitis.
• The ASP did not effectively reduce the prescription of broad-spectrum antibiotics or macrolides.