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Clinician education reduced inappropriate antibiotic prescribing

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SAN DIEGO — Data from a recent study presented at ID Week 2012 showed that quarterly monitoring and feedback of pediatricians’ prescribing practices cut inappropriate antibiotic use almost in half.

“Most antibiotics are given in the outpatient setting,” Jeffrey Gerber, MD, assistant professor of pediatrics at The Children’s Hospital of Philadelphia, said during a media briefing. “For children, the most common infections for which antibiotics are indicated actually have prescribing guidelines published by national organizations. Children with acute respiratory tract infections are an excellent target for antimicrobial stewardship.”

Gerber and colleagues conducted a cluster-randomized trial in a network of primary care outpatient offices in which they block-randomized 18 practices to intervention or control. The intervention included an onsite clinician educational session and a quarterly audit and feedback of antibiotic prescribing for sinusitis, group A streptococcal pharyngitis and pneumonia.

One year after the intervention, off-guideline prescribing of antibiotics in the intervention group decreased from 32% to 14%. In the control group, it decreased from 33% to 23%. The most significant effect was seen on the inappropriate use of antibiotics for pneumonia: This reduced from 16% to 4%. For strep throat, there was little change, and for sinusitis, the inappropriate prescription of antibiotics dropped by half.

“The impact in the intervention group was much better than we thought it would be,” Gerber said. “It shows that getting people up to speed with current guidelines and providing simple reminders are helpful. It also shows that you can leverage electronic health records to put together a relatively low-maintenance system to improve prescribing.”

For more information:

Gerber J. #36564. Presented at: ID Week 2012; Oct. 16-19, 2012; San Diego.

Disclosure: Gerber reports no relevant financial disclosures.