ArticlePediatrics2021
Improving Delayed Antibiotic Prescribing for Acute Otitis Media.
Article in Pediatrics, 2021. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 15 papers, 1 of them a synthesis that pooled it.
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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.
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Who cites it
15 citing papers in PubMed, 1 synthesis or guideline pooled it, 23 citations in OpenAlex.
- Influence of potentially harmful sucking habits on otitis media in children: a systematic review and meta-analysis.Brazilian oral research · 2025Pooled it
- Antibiotic treatment of acute otitis media: has watchful waiting gone with the diagnosis?CJEM · 2026Article
- Cost to implement an outpatient stewardship intervention for acute otitis media (AOM).Antimicrobial stewardship & healthcare epidemiology : ASHE · 2026Article
- Increasing Safety Net Antibiotic Prescriptions for Acute Otitis Media in Urgent Care Clinics.Journal of pediatrics. Clinical practice · 2024Article
- Interventions to de-implement unnecessary antibiotic prescribing for ear infections (DISAPEAR Trial): protocol for a cluster-randomized trial.BMC infectious diseases · 2024Article
- Next Steps in Ambulatory Stewardship.Infectious disease clinics of North America · 2023Review
- New insights into the treatment of acute otitis media.Expert review of anti-infective therapy · 2023Review
- Utilization of nonguideline concordant antibiotic treatment following acute otitis media in children in the United States.Pharmacoepidemiology and drug safety · 2023Article
- Sustainability of Interventions to Increase Guideline-Concordant Durations of Antibiotic Therapy for Children with Acute Otitis Media.The Journal of pediatrics · 2023Article
- Nasopharyngeal rapid diagnostic testing to reduce unnecessary antibiotic use and individualize management of acute otitis media.Antimicrobial stewardship & healthcare epidemiology : ASHE · 2023Article
- Attitudes of primary care physicians towards antimicrobial stewardship and the impact of a multi-part training course - a pilot study.GMS hygiene and infection control · 2023Article
- Amoxicillin Versus Other Antibiotic Agents for the Treatment of Acute Otitis Media in Children.The Journal of pediatrics · 2022Article
- A Baker's Dozen of Top Antimicrobial Stewardship Intervention Publications in Non-Hospital Care Settings in 2021.Open forum infectious diseases · 2022Review
- A Multisite Collaborative to Decrease Inappropriate Antibiotics in Urgent Care Centers.Pediatrics · 2022Article
- Caregiver perspectives and preferences for acute otitis media management.Antimicrobial stewardship & healthcare epidemiology : ASHE · 2021Article
Corrections and comments
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Authors and funding
7 authors at 5 institutions in 1 country.
Funding
Abstract
objectivesAcute otitis media (AOM) is the most-common indication for antibiotics in children. Delayed antibiotic prescribing for AOM can significantly reduce unnecessary antibiotic use and is recommended by the American Academy of Pediatrics for select children. We sought to improve delayed prescribing for AOM across 8 outpatient pediatric practices in Colorado.
methodsThrough a collaborative initiative with American Academy of Pediatrics and the Centers for Disease Control and Prevention, we implemented an economical 6-month antimicrobial stewardship intervention that included education, audit and feedback, online resources, and content expertise. Practices used The Model for Improvement and plan-do-study-act cycles to improve delayed antibiotic prescribing. Generalized estimating equations were used to generate relative risk ratios (RRRs) for outcomes at the intervention end and 3- and 6-months postintervention. Practice surveys were evaluated.
resultsIn total, 69 clinicians at 8 practice sites implemented 27 plan-do-study-act cycles. Practices varied by size (range: 6-37 providers), payer type, and geographic setting. The rate of delayed antibiotic prescribing increased from 2% at baseline to 21% at intervention end (RRR: 8.96; 95% confidence interval [CI]: 4.68-17.17). Five practices submitted postintervention data. The rate of delayed prescribing at 3 months and 6 months postintervention remained significantly higher than baseline (3 months postintervention, RRR: 8.46; 95% CI: 4.18-17.11; 6 months postintervention, RRR: 6.69; 95% CI: 3.53-12.65) and did not differ from intervention end (3 months postintervention, RRR: 1.12; 95% CI: 0.62-2.05; 6-months postintervention, RRR: 0.89; 95% CI: 0.53-1.49).
conclusionsBaseline rate of delayed prescribing was low. A low-cost intervention resulted in a significant and sustained increase in delayed antibiotic prescribing across a diversity of settings.
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Registered trials
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