Antibiotic Prescribing Education And Pediatrician Feedback Improves Care For Children With Common Infections

INTRO: Prescribing antibiotics for children is very common. About 75 percent of these medications are given to treat acute respiratory tract infections or A-R-T-I’s. A new study evaluated whether pediatricians who were updated about current prescribing guidelines and given feedback about the prescriptions they wrote would prescribe these drugs more effectively. Catherine Dolf explains in this week’s JAMA Report.

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Parents and baby with doctor in office

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MOST VISITS TO A PEDIATRICIAN’S OFFICE LIKE THIS ONE ARE ROUTINE.

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NATSO/FULL Runs:04
“…the other thing we’re doing today is we’re going to be giving our first set of immunizations…”

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Pediatrician examining child, Graphic: Accute Respiratory Infections (ARTI’S)
Wipe in:
Sinus Infections
Strep Throat
Pneumonia

Wipe in: 2 bottles penicillin and
Amoxicillin, third bottle in: broad spectrum antibiotics

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HOWEVER, SOMETIMES THEY ARE NOT. CHILDREN OFTEN SEE THEIR PHYSICIANS FOR A VARIETY OF ILLNESSES INCLUDING, ACUTE RESPIRATORY TRACT INFECTIONS OR A-R-T-I’S. SOME OF THE MOST COMMON ARE SINUS INFECTIONS, STREP THROAT AND PNEUMONIA. THE AMERICAN ACADEMY OF PEDIATRICS RECOMMENDS PENICILLIN OR AMOXICILLIN AS FIRST LINE AGENTS TO TREAT THESE INFECTIONS, BUT ABOUT 50 PERCENT OF CHILDREN RECEIVE BROADER SPECTRUM ANTIBIOTICS.

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SOT/FULL Super @:29 Jeffrey S. Gerber, M.D., Ph.D., – The Children’s Hospital of Philadelphia Runs:11
“The two main goals were to make sure that kids were getting the right drug to best cure their infections and to make sure that we avoided kids getting drugs they didn’t need.”

(Video covering 2nd half of bite: antibiotic bottles)

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Dr. Gerber and colleague walking, looking at computer, pediatrician examining baby, going over health records, typing at computer in exam room

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DR. JEFFREY GERBER FROM THE CHILDREN’S HOSPITAL OF PHILADELPHIA AND CO-AUTHORS STUDIED 18 PEDIATRIC PRIMARY CARE PRACTICES SHARING A COMMON ELECTRONIC HEALTH RECORD.  PHYSICIANS IN 9 OF THOSE PRACTICES WERE PROVIDED A ONE-HOUR EDUCATION SESSION ABOUT CURRENT PRESCRIBING GUIDELINES. THE PHYSICIANS WERE ALSO GIVEN ONE YEAR OF PERSONALIZED FEEDBACK ON HOW THEY USED THOSE GUIDELINES WHEN PRESCRIBING MEDICATIONS FOR VIRAL AND BACTERIAL A-R-T-I’S. PHYSICIANS IN THE 9 OTHER PRACTICES PRESCRIBED MEDICATION WITHOUT THE INTERVENTION.

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SOT/FULL Super @1:06 Jeffrey S. Gerber, M.D., Ph.D., – The Children’s Hospital of Philadelphia Runs:13
“Off guideline prescribing for these common infections decreased by nearly 50 percent for pediatricians who received the education and feedback.”

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JAMA COVER

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THE STUDY APPEARS IN JAMA, JOURNAL OF THE AMERICAN MEDICAL ASSOCIATION.

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SOT/FULL Super @1:23 Jeffrey S. Gerber, M.D., Ph.D., – The Children’s Hospital of Philadelphia Runs:09
“And specifically for patients with pneumonia the intervention reduced off guideline prescribing by 75 percent.”

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Dr. Gerber and colleague going over data

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RESEARCHERS SAY THIS WAS A RELATIVELY SIMPLE INTERVENTION THAT PRODUCED LARGE BENEFITS.

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SOT/FULL Super @1:36 Jeffrey S. Gerber, M.D., Ph.D., – The Children’s Hospital of Philadelphia Runs:11
“Parents should be confident that we have a way to get kids the right drugs at the right time to best cure their infections while minimizing unnecessary side effects.”

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Mom holding baby

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CATHERINE DOLF, THE JAMA REPORT.

TAG: PRIOR RESEARCH HAS SHOWN THAT UNNECESSARY PRESCRIBING FOR VIRAL ACUTE RESPIRATORY TRACT INFECTIONS HAD BEEN DECLINING.