ArticleJournal of managed care & specialty pharmacy2018
Failure of a Best Practice Alert to Reduce Antibiotic Prescribing Rates for Acute Sinusitis Across an Integrated Health System in the Midwest.
Article in Journal of managed care & specialty pharmacy, 2018. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 14 papers, 2 of them syntheses that pooled it.
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The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.
Who cites it
14 citing papers in PubMed, 2 syntheses or guidelines pooled it, 27 citations in OpenAlex.
- The Effect of Computerized Alerts on Prescribing and Patient Outcomes: A Systematic Review.Applied clinical informatics · 2025Pooled it
- Chinese herbal therapy in the management of rhinosinusitis-A systematic review and meta-analysis.PloS one · 2022Pooled it
- Education vs Clinician Feedback on Antibiotic Prescriptions for Acute Respiratory Infections in Telemedicine: a Randomized Controlled Trial.Journal of general internal medicine · 2021Trial
- Impact of a multifaceted intervention including supportive care order sentence implementation on outpatient antibiotic prescribing for upper respiratory tract infections.Antimicrobial stewardship & healthcare epidemiology : ASHE · 2025Article
- Use of electronic health record best practice alerts to improve adherence to American Urological Association vesicoureteral reflux guidelines.Pediatric surgery international · 2022Article
- Usability and Utility of Human Immunodeficiency Virus Pre-exposure Prophylaxis Clinical Decision Support to Increase Knowledge and Pre-exposure Prophylaxis Initiations among Pediatric Providers.Applied clinical informatics · 2022Article
- Antibiotic Prescribing Practices for Upper Respiratory Tract Infections Among Primary Care Providers: A Descriptive Study.Open forum infectious diseases · 2022Article
- Clinicians' Intention to Submit Microbiological Pathogenic Test Before Antibiotics Use and Its Influencing Factors: New Evidence from the Perspective of Hospital Management.Infection and drug resistance · 2022Article
- Pediatric Provider Utilization of a Clinical Decision Support Alert and Association with HIV Pre-exposure Prophylaxis Prescription Rates.Applied clinical informatics · 2022Article
- Implementation of Veterans Affairs Primary Care Antimicrobial Stewardship Interventions For Asymptomatic Bacteriuria And Acute Respiratory Infections.Open forum infectious diseases · 2021Article
- Antibiotic procurement and ABC analysis for a comprehensive primary health care clinic in the Eastern Cape province, South Africa.Southern African journal of infectious diseases · 2020Article
- Impact of a Multifaceted Antimicrobial Stewardship Intervention in a Primary Health Care Area: A Quasi-Experimental Study.Frontiers in pharmacology · 2020Article
- Antimicrobial Stewardship Interventions to Combat Antibiotic Resistance: an Update on Targeted Strategies.Current infectious disease reports · 2019Review
- Limiting Antibiotic Use in Acute Sinusitis: Partly a Matter of Vocabulary?Journal of patient-centered research and reviews · 2018Article
Corrections and comments
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Authors and funding
4 authors at 1 institution in 1 country.
Funding
No grant is acknowledged in the PubMed record.
Abstract
backgroundAntimicrobial resistance is a growing concern, and in recent years, there has been increased interest in ambulatory antimicrobial stewardship. Acute rhinosinusitis (ARS) is one of the most common outpatient diagnoses that results in an antibiotic prescription.
objectiveTo determine if a best practice alert (BPA) will affect the percentage of oral antibiotic prescriptions for adults with ARS.
methodsA prospective, pre/post study was initiated to evaluate the percentage of oral antibiotic prescriptions for ARS in 117 primary care clinics in the Midwest. Included in the study results were 16,570 adults who had an office visit for ARS: 8,106 patients from December 1, 2015, to February 28, 2016, were in the pre-intervention group without an active BPA, and 8,464 patients from December 1, 2016, to February 28, 2017, were in the post-intervention group when the BPA was active. The primary outcome was the number of oral antibiotic prescriptions for ARS compared with the number of office visits for ARS in the pre- and postintervention groups.
resultsThe percentage of oral antibiotics prescribed for the pre- and postintervention groups were 94.8% and 94.3%, respectively (P = 0.152). The BPA displayed for 7,780 visits, prompting discontinuation of an antibiotic for 10 (0.1%) visits in the postintervention group.
conclusionsThis study suggests that, although an electronic alert may be attractive to facilitate antimicrobial stewardship, it may be ineffective. These results warrant alternative measures to facilitate ambulatory antimicrobial stewardship. DISCLOSURES: No outside funding supported this study. The authors have no conflicts of interest to declare. Study concept and design were contributed by Hansen, D. Leedahl, and N. Leedahl. Hansen and N. Leedahl took the lead in data collection, with assistance from Carson and D. Leedahl. Data interpretation was performed by all the authors. The manuscript was written by Hansen, along with the other authors, and revised by all the authors.
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