A quality improvement program can improve recommended antibiotic duration in children for both acute otitis media (AOM) and community-acquired pneumonia (CAP) across multiple care delivery settings, according to a study presented at the annual meeting of the Pediatric Academic Societies, held from April 24 to 28 in Honolulu.

Elysha Pifko, M.D., from Nemours Children’s Hospital in Wilmington, Delaware, and colleagues scaled a quality improvement initiative aimed at creating clinical pathways for treatment of AOM and CAP throughout a health care system that included two emergency departments, 67 primary care sites, and three urgent care sites in three states (26,896 patients).

The researchers reported that adherence to recommended antibiotic treatment duration for AOM and CAP combined increased from 51 to 83%, with no change in the proportion of patients requiring a second prescription. The goal of 80% was exceeded in the emergency department and primary care sites, with an upward trend in urgent care. For CAP, systemwide adherence to treatment duration increased from 39 to 72% and from 59 to 81% for AOM, with center-line shifts. For CAP (mean 7.6 days to six days) and AOM (mean 8.5 days to 6.8 days in patients 2 years and older), the average durations for prescribed antibiotics decreased.

“Scaling from one department to an entire health care system across the continuum proved to be an effective strategy,” the authors write.

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