Prescribing and Dispensing Delayed Antibiotics for Pediatric Patients with Otitis Media and Pharyngitis.

Abstract

Background: Providing patients with a delayed prescription for antibiotics to treat acute otitis media (AOM) or pharyngitis may result in decreased antibiotic use.

Objectives: To characterize antibiotic prescribing for patients discharged from a pediatric emergency department (PED) with AOM or pharyngitis and to determine the percentage of delayed antibiotic prescriptions dispensed prematurely by a community pharmacy.

Methods: This study was completed by linking provincial administrative data on prescriptions dispensed from community pharmacies and a retrospective chart review at a single PED. The study included any pediatric patient who was seen in the PED between March 2019 and February 2021, given a diagnosis of AOM or pharyngitis, and discharged with a prescription for an antibiotic. Patient data were collected from scanned medical records. The chart review was linked to records for dispensed antibiotics in the provincial drug information system. Results were summarized and reported descriptively.

Results: A total of 1569 (53.3%) of the 2945 patients seen in the PED with the diagnoses of interest received a prescription for an antibiotic. Delayed prescriptions were given in 21.2% (332/1569) of these encounters. An antibiotic was dispensed within 7 days of the PED visit for fewer than half of the patients (40.4%, 134/332) who received a delayed prescription. About a third of caregivers filled delayed prescriptions within 48 hours (30.1%, 100/332), and 16.9% (43/254) did so earlier than advised.

Conclusion: Caregivers who were given a discharge prescription for a delayed antibiotic generally adhered to guidance provided by prescribers and waited to fill the prescription. This strategy may reduce overuse of antibiotics.