Unnecessary Prescription Of Childhood Respiratory Antibiotics Reduced With Distance Learning Program: Study

A new study suggests online training courses for doctors helped to reduce unnecessary antibiotic prescriptions for children by up to 40%.

Roughly one-third of pediatric antibiotic prescriptions for respiratory infections are unnecessary and inappropriate, according to experts, which may increase the risk of antibiotic-resistant infections and other side effects.

According to a report published in the September issue of the journal Pediatrics, the new online training for doctors helped to reduce those prescriptions, suggesting that more focus should be put on education and increasing awareness among medical providers.

Researchers with the University of Washington evaluated the effectiveness of a distance learning program for reducing outpatient antibiotic prescribing for pediatric respiratory infections. The study included 50 doctors at 19 pediatric practices in the Pediatric Research in Office Settings Network or the NorthShore University HealthSystem. The clinical trial ran from November 2015 to June 2018.

The study involved nearly 73,000 office visits by 30,000 patients for acute otitis media, or ear infection, bronchitis, pharyngitis, sinusitis, or sinus infection, and upper respiratory infection among children 6 months to 11 years old.

Doctors in the study received intervention as a three-program module containing online tutorials and webinars on evidence-based communication strategies and antibiotic prescribing with individualized antibiotic feedback reports over 11 months.

Overall, the web-based training helped to reduce the likelihood a doctor would prescribe antibiotics for respiratory infections by 7%. It helped reduce any antibiotic prescribing for viral respiratory infections by up to 40%.

Antibiotics are often prescribed to patients in outpatient settings without a documented reason. In fact, half of all antibiotic prescriptions are given without a diagnosis for an infection and 20% of those are given without even visit to the doctor’s office.

The researchers in the latest study noted second-line antibiotic prescribing decreased for streptococcal pharyngitis and sinusitis, but there was no reduction in antibiotic prescriptions for ear infections.

Antibiotic prescribing for acute respiratory tract infections accounts for more than 70% of all antibiotics prescribed for children. Data indicates one-third of those outpatient antibiotic prescriptions for pediatric respiratory infections are inappropriate or unnecessary, attempting to treat viral infections that cannot be treated with antibiotics.

One study indicated giving antibiotics to treat bronchitis was no more effective at treating the condition than treating the patient with a placebo. Most cases of bronchitis are caused by viral infections, which are not affected by antibiotics. Yet many patients still ask for them and many doctors prescribe them in these situations, even though the antibiotics won’t help.

Using this training across the country could help reduce all pediatric respiratory infection visits by 1.5 million prescriptions, the researchers noted, suggesting broader dissemination of the training program would be beneficial.