A Quality Improvement Endeavor to Improve Antibiotic Prescribing for Children with Acute Otitis Media in Emergency and Urgent Care Settings

Acute otitis media (AOM) self-resolves without antibiotics in 60-75% of cases. A study evaluated the impact of an electronic health record (EHR) order set and a local clinical care pathway (CCP) on antibiotic prescribing for pediatric AOM. The study included 34,324 patients and found that the EHR order set resulted in shorter antibiotic durations for AOM patients older than 24 months. Antibiotic prescribing rates increased, while amoxicillin prescribing decreased. The study suggests that further dissemination of the new CCP and de-implementation of previous practices is needed to improve antibiotic prescribing and first-line antibiotic use. The amoxicillin shortage likely played a role in decreased prescribing rates.