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Antibiotic stewardship initiatives in urgent care may improve prescribing practices beyond just their original objectives, according to a study published in the Journal of the Pediatric Infectious Diseases Society. A national quality improvement collaborative involving 92 pediatric urgent care sites examined antibiotic prescribing duration for acute respiratory infections in children aged 6 months–18 years. Researchers analyzed 257,879 encounters involving antibiotic prescriptions between April 2022 and September 2024. Although the program focused on improving first-line antibiotic selection rather than treatment duration, there was a unique spillover effect observed: The proportion of prescriptions written for 7 days or less increased from 33.4% before the intervention to 35.9% during the intervention and 37.8% afterward. The greatest improvement occurred for sinusitis, with short-course prescribing increasing from 11.2% to 33.9%. The researchers generally considered antibiotic courses of 7 days or less as a desirable prescribing outcome, knowing that shorter antibiotic courses are increasingly recommended for many uncomplicated pediatric respiratory infections—but are not necessarily the appropriate standard for every infection or patient. The study measured how frequently clinicians prescribed courses of 7 days or less but did not determine which individual prescriptions were clinically appropriate. Even so, the authors believe awareness, collaboration, culture, and documentation upgrades around antibiotic prescribing may have contributed to the duration improvements.
Targeted programs: Overall, most antibiotic prescriptions analyzed in the study exceeded 7 days, and substantial variation persisted among urgent care sites. Read more about a campaign at Denver Health urgent care centers that improved appropriate antibiotic duration from the JUCM archive: Campaign Increases Urgent Care Adherence to 5-Day Antibiotic Prescribing