Work

Effect of Antibiotic Duration Option Buttons in the Electronic Medical Record on Outpatient Antibiotic Prescribing in Pediatrics

Year: 2016

Type: article

Abstract: Background. Most antibiotics for children are prescribed in the outpatient setting. Evidence-based recommendations for antibiotic duration for common infections are rare, and duration prescribing practices vary widely. Antibiotic stewardship interventions in ambulatory settings are labor intensive and difficult to implement. Effect of DOBs on antibiotic duration Figure 1. Methods. In February 2015, we introduced duration option buttons (DOBs) into the electronic medical record for antibiotic prescribing. Prescribers were provided DOBs with shorter duration options (≤10 days), without preferences or guidelines, but any duration could be manually entered. We then assessed antibiotic durations for 6 antibiotics prescribed during emergency room or outpatient visits. We compared antibiotic durations between the 3-year pre-intervention and 1-year post-intervention periods. Generalized estimating equation models were used to evaluate the effects of the intervention, time, setting, and medication. A spline term at the date of intervention was included in all models. Results. Overall, between the pre-intervention period (20,775 antibiotic courses) and the post-intervention period (6203 antibiotic courses), duration decreased by 0.2 days per antibiotic course (p = 0.002). There was a highly significant 0.6 day per antibiotic course reduction for clindamycin (figure 1), and marginally significant intervention effects for trimethoprim-sulfamethoxazole (TMP-SMX; p = 0.055) and cephalexin (p = 0.061). Had the DOBs been instituted in 2012, we estimate saving 5668 antibiotic days ($72,833) for clindamycin, TMP-SMX, and cephalexin over the 4-year study period. Conclusion. The simple provision of DOBs can lead to decreased antibiotic durations, and offer a low cost option to decrease antibiotic use in the outpatient setting. Disclosures. All authors: No reported disclosures

Source: Open Forum Infectious Diseases

DOI: 10.1093/ofid/ofw172.1483

Authors: Marielle Fricchione, Hannah Palac, Daniel Healy, Rupal Patel, Larry Kociolek, Sameer Patel

Institutions: Lurie Children's Hospital, Northwestern University

Language: English

Topic: Antibiotic Use and Resistance

Subfield: Applied Microbiology and Biotechnology

Field: Immunology and Microbiology

Domain: Life Sciences

SDG: Good health and well-being

Open Access status: gold

Estimated APC paid: $4,053