Preset Treatment Orders Improve Antibiotic Prescribing Practices

Preset Treatment Orders Improve Antibiotic Prescribing Practices

AT A GLANCE

• Including default antibiotic prescribing guidance in the electronic medical records of children with acute ear infections improved compliance with treatment guidelines.
• Researchers found that including the guidance shortened the average recommended course of antibiotics to be in line with the most current guidelines.
• The results suggest inclusion of default recommendations could help advance appropriate antibiotic use and slow the advancement of antimicrobial resistance.

A new method for prescribing antibiotics improved compliance with treatment guidelines and shortened antibiotic use in children with ear infections in emergency and urgent care settings, according to new findings presented at IDWeek 2024.

The study found that compliance with antibiotic recommendations for children two years of age and older increased from 3% to 83% when preset interventions were integrated into medical records for children with acute otitis media, a common ear infection. The findings add to a growing body of research that demonstrates the effectiveness of practical steps to improve antibiotic prescribing to combat resistance and prevent adverse drug events from antibiotics.

Researchers analyzed the medical records of children aged 61 days to 18 years who visited emergency or urgent care centers for AOM between January 2019 and September 2023. If AOM was confirmed, the researchers looked at the type and duration of antibiotics prescribed and the change in long (seven or 10 days) to short (five days) duration of antibiotics in children two years of age and older after a preset intervention. The data are based on 34,324 patients at the University of Colorado/Children's Hospital Colorado.

"Including default recommendations in electronic health records can increase compliance with treatment guidelines, a critical element of antibiotic stewardship," said Joana Dimo, doctoral fellow at the University of Colorado and presenting author. "Reducing the duration of antibiotic regimens will help treatments remain effective in the face of increasing, dangerous antimicrobial resistance and prevent harm from antibiotics." One in four children prescribed amoxicillin will have an adverse drug event such as diarrhea, vomiting or a rash.

Five out of six children have at least one ear infection before they are three years old, according to the National Institutes of Health. Approximately 80% of children diagnosed with ear infections in the United States do not require antibiotics for treatment, researchers say, but many still receive unnecessary prescriptions, often for inappropriately long periods.

In addition to Joana Dimo, study co-authors include: Matthew J. Weber, MPH; Meghan C. Birkholz, MSPH; Irina Topoz, MD; and Nicole M. Poole, MD, MPH.

About IDWeek
IDWeek is the joint annual meeting of the Infectious Diseases Society of America, the Society for Healthcare Epidemiology of America, the HIV Medicine Association, the Pediatric Infectious Diseases Society and the Society of Infectious Diseases Pharmacists. IDWeek is a recognized forum for peer-reviewed presentations of new research on scientific advances and bench-to-bedside approaches in prevention, diagnosis, treatment and epidemiology of infectious diseases including HIV, across the lifespan. For more information, visit idweek.org.