Impact of an Educational Intervention to Improve Antibiotic Prescribing for Nurse Practitioners in a Pediatric Urgent Care Center.

BACKGROUND: Up to 21% of pediatric visits result in an antibiotic prescription, and a large portion of these are unnecessary.

OBJECTIVE: To determine if educational sessions would reduce inappropriate antibiotic use.

METHODS: Intervention study evaluating antibiotic prescribing following educational sessions for urinary tract infection, skin and soft tissue infection, pharyngitis, upper respiratory tract infection, acute otitis media, and acute bacterial sinusitis.

RESULTS: A total of 26 out of 43 (60%) nurse practitioners in 4 urgent care centers were enrolled in the study. The rate of inappropriate antibiotic use among all conditions was 10% before and 8% after the intervention (p = .02). A decrease in inappropriate antibiotic prescribing was seen after the educational session (p < .01). The most common reasons for inappropriate antibiotic prescribing were too broad (41%), wrong dosage (22%), and not indicated (17%).

CONCLUSIONS: Educational sessions led to improvement in overall inappropriate antibiotic use. Additional stewardship interventions are needed to further reduce unnecessary antibiotic use.