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.