Trial reportPediatrics2020
Reducing Antibiotic Prescribing in Primary Care for Respiratory Illness.
Trial report in Pediatrics, 2020. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 47 papers, 3 of them syntheses that pooled it.
What it found
Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.
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
47 citing papers in PubMed, 3 syntheses or guidelines pooled it, 96 citations in OpenAlex.
- Audit and feedback: effects on professional practice.The Cochrane database of systematic reviews · 2025Pooled it
- Audit and Feedback Interventions for Antibiotic Prescribing in Primary Care: A Systematic Review and Meta-analysis.Clinical infectious diseases : an official publication of the Infectious Diseases Society of America · 2025Pooled it
- Nudge interventions to reduce unnecessary antibiotic prescribing in primary care: a systematic review.BMJ open · 2023Pooled it
- Improving Outpatient Antibiotic Prescribing for Respiratory Tract Infections in Primary Care: A Stepped-Wedge Cluster Randomized Trial.Clinical infectious diseases : an official publication of the Infectious Diseases Society of America · 2022Trial
- Primary Care Telemedicine vs In-Person Antibiotic Prescribing for Pediatric Respiratory Tract Infections.JAMA network open · 2026Article
- Urgent Care Stewardship for Glucocorticoid Overuse in Acute Respiratory Infections.JAMA network open · 2026Article
- Impact of the COVID-19 Pandemic on the Outcomes of a Multifaceted Program on Antibiotic Prescribing in Primary Care Among Children Under Three Years of Age.Antibiotics (Basel, Switzerland) · 2026Article
- The influence of social relationships on clinician interpretation of performance data in an outpatient antibiotic stewardship intervention.Antimicrobial resistance and infection control · 2025Article
- Unbeneficial effects of not prescribing antibiotics to pediatric patients with acute upper respiratory infection: a descriptive epidemiological study based on a large Japanese medical claim database.Journal of pharmaceutical health care and sciences · 2025Article
- Impact of an Educational Leaflet About Asymptomatic Bacteriuria and Urinary Tract Infection on Antibiotic Preferences Among US Adults ≥65 Years: An Online Randomized Controlled Survey Experiment.Open forum infectious diseases · 2025Article
- Development and assessment of an online communication skills course to optimise antibiotic prescribing for children in primary care.BMC primary care · 2025Article
- Clinicians' Reasons for Non-Visit-Based, No-Infectious-Diagnosis-Documented Antibiotic Prescribing: A Sequential Mixed-Methods Study.Antibiotics (Basel, Switzerland) · 2025Article
- Rapid diagnosis of acute pediatric respiratory infections with Point-of-Care and multiplex molecular testing.Infection · 2025Review
- 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
- Prescribing Patterns of High Opioid and Antibiotic Prescribers, Washington State, 2021: Do Some Prescribers Have Trouble Saying No?Open forum infectious diseases · 2024Article
- Eliciting Clinician Perspectives on Asymptomatic Bacteriuria to Identify Targets for Antimicrobial Stewardship Education and Decision Support.Open forum infectious diseases · 2024Article
- The Effectiveness of a Dietary Supplement with Honey, Propolis,Pharmaceuticals (Basel, Switzerland) · 2024Article
- RSV Disease Burden in Primary Care in Italy: A Multi-Region Pediatric Study, Winter Season 2022-2023.Influenza and other respiratory viruses · 2024Article
- Antibiotic Receipt for Pediatric Telemedicine Visits With Primary Care vs Direct-to-Consumer Vendors.JAMA network open · 2024Article
- Article
Corrections and comments
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Authors and funding
16 authors at 7 institutions in 1 country.
Funding
Abstract
backgroundOne-third of outpatient antibiotic prescriptions for pediatric acute respiratory tract infections (ARTIs) are inappropriate. We evaluated a distance learning program's effectiveness for reducing outpatient antibiotic prescribing for ARTI visits.
methodsIn this stepped-wedge clinical trial run from November 2015 to June 2018, we randomly assigned 19 pediatric practices belonging to the Pediatric Research in Office Settings Network or the NorthShore University HealthSystem to 4 wedges. Visits for acute otitis media, bronchitis, pharyngitis, sinusitis, and upper respiratory infection for children 6 months to <11 years old without recent antibiotic use were included. Clinicians received the intervention as 3 program modules containing online tutorials and webinars on evidence-based communication strategies and antibioti c 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. Mixed-effects logistic regression compared prescribing rates during each program module and a postintervention period to a baseline control period. Odds ratios were converted to adjusted rate ratios (aRRs) for interpretability.
resultsAmong 72 723 ARTI visits by 29 762 patients, intention-to-treat analyses revealed a 7% decrease in the probability of antibiotic prescribing for ARTI overall between the baseline and postintervention periods (aRR 0.93; 95% confidence interval [CI], 0.90-0.96). Second-line antibiotic prescribing decreased for streptococcal pharyngitis (aRR 0.66; 95% CI, 0.50-0.87) and sinusitis (aRR 0.59; 95% CI, 0.44-0.77) but not for acute otitis media (aRR 0.93; 95% CI, 0.83-1.03). Any antibiotic prescribing decreased for viral ARTIs (aRR 0.60; 95% CI, 0.51-0.70).
conclusionsThis program reduced antibiotic prescribing during outpatient ARTI visits; broader dissemination may be beneficial.
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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.