The efficacy of a program aimed to reduce inappropriate outpatient antibiotic prescribing for paediatric acute respiratory tract infections (ARTIs) has been evaluated in a recently published stepped-wedge clinical trial. 72,723 ARTI visits by 29,762 patients were involved in the study. The multi-modal intervention involved 3 program modules containing online tutorials and webinars on evidence-based communication strategies and antibiotic prescribing, booster video vignettes, and individualized antibiotic prescribing feedback reports over 11 months. The primary outcome was overall antibiotic prescribing rates for all ARTI visits.A 7% reduction in the likelihood of ARTI antibiotic prescribing between the baseline and post-intervention periods was reported following intention-to-treat analyses (adjusted rate ratio: 0.93; 95% CI: 0.90-0.96). Specifically, second-line antibiotic prescribing was reduced for both streptococcal pharyngitis and sinusitis, with adjusted rate ratios reported as 0.66 (0.50-0.87) and 0.59 (0.44-0.77), respectively. The study also assessed cases of otitis media, bronchitis and upper respiratory infection, however reduction in antibiotic prescribing following program implementation was not significant for these conditions. Despite this, it was concluded overall antibiotic prescribing for paediatric ARTI visits was reduced and that further distribution of the program could assist in reaching national goals of reducing inappropriate prescribing among this cohort. The article can be accessed here.
Contributed bu Isabella Singh, AMSS Associate.