Optimal Pediatric Outpatient Antibiotic Prescribing

A study in Tennessee found that less than one-third of pediatric outpatient antibiotics prescribed are optimal for choice and duration. The study analyzed data from 488 clinical encounters for patients under 20 years with at least one prescription for oral antibiotics, intramuscular ceftriaxone, or penicillin. The most common indications were acute otitis media (AOM) and pharyngitis, with 67.3% of AOM and 55.9% of pharyngitis being optimal for antibiotic choice. Only 5.7% of antibiotics prescribed for community-acquired pneumonia had a 5-day duration. The study suggests four stewardship interventions: reducing the number of prescriptions for tier 3 diagnoses, increasing optimal prescribing for AOM and pharyngitis, providing clinician education on shorter antibiotic treatment courses, and promoting optimal antibiotic prescribing in resource-limited settings.