EHR order set reduces antibiotic duration in children with acute otitis media

Implementation of an electronic health record (EHR) order set increases compliance with the recommended duration of prescribed antibiotics for children with acute otitis media (AOM), according to a study presented at the annual meeting of the Infectious Diseases Society of America (IDWeek), held from Oct. 16 to 19 in Los Angeles.

Joana Dimo, D.O., from the University of Colorado/Children’s Hospital Colorado in Denver, and colleagues examined the impact of a quality improvement intervention on antibiotic prescribing for pediatric AOM.

The bundled intervention included an EHR order set that preselected a five-day antibiotic duration for children aged 24 months and older and creation of a local clinical care pathway, which encouraged observation and pain management in children aged 24 months and older and those aged 6 to 23 months with unilateral, nonsevere AOM.

Patients aged 61 days to 18 years presenting to emergency departments and urgent care centers were reviewed; data were included for 34,324 patients.

The researchers found that throughout the study, rates of antibiotic prescribing remained high (88 to 93 percent), with special cause variation. After development of the EHR order set, there was an increase in compliance with the recommended duration of antibiotics of five days or fewer (3 to 83 percent). Throughout the study, the rates of amoxicillin prescribing decreased (77 to 74 percent).

“Reducing the duration of antibiotic regimens will help treatments remain effective in the face of increasing, dangerous antimicrobial resistance and prevent harm from antibiotics,” Dimo said in a statement.

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