Impact of a Personalized Audit and Feedback Intervention on Antibiotic Prescribing Practices for Outpatient Pediatric Community-Acquired Pneumonia

Clin Pediatr (Phila). 2020 Oct;59(11):988-994. doi: 10.1177/0009922820928054. Epub 2020 Jun 2.

Abstract

Antibiotic choice for pediatric community-acquired pneumonia (CAP) varies widely. We aimed to determine the impact of a 6-month personalized audit and feedback program on primary care providers' antibiotic prescribing practices for CAP. Participants in the intervention group received monthly personalized feedback. We then analyzed enrolled providers' CAP antibiotic prescribing practices. Participants diagnosed 316 distinct cases of CAP (214 control, 102 intervention); among these 316 participants, 301 received antibiotics (207 control, 94 intervention). In patients ≥5 years, the intervention group had fewer non-guideline-concordant antibiotics prescribed (22/103 [21.4%] control; 3/51 [5.9%] intervention, P < .05) and received more of the guideline-concordant antibiotics (amoxicillin and azithromycin). Personalized, scheduled audit and feedback in the outpatient setting was feasible and had a positive impact on clinician's selection of guideline-recommended antibiotics. Audit and feedback should be combined with other antimicrobial stewardship interventions to improve guideline adherence in the management of outpatient CAP.

Keywords: audit and feedback; community-acquired pneumonia; pediatric.

Publication types

  • Research Support, U.S. Gov't, Non-P.H.S.

MeSH terms

  • Anti-Bacterial Agents / therapeutic use*
  • Antimicrobial Stewardship / organization & administration*
  • Attitude of Health Personnel
  • Child
  • Community-Acquired Infections / drug therapy*
  • Community-Acquired Infections / prevention & control
  • Drug Prescriptions
  • Feasibility Studies
  • Female
  • Guideline Adherence
  • Humans
  • Male
  • Outpatients / statistics & numerical data
  • Pneumonia / drug therapy*
  • Pneumonia / prevention & control
  • Practice Patterns, Physicians' / statistics & numerical data*

Substances

  • Anti-Bacterial Agents