Background: Recent Infectious Disease Society of America (IDSA) guidelines indicate that antibiotic treatment for pharyngitis should await laboratory confirmation. Nevertheless, many children are still treated presumptively.
Aim: The goal of the study was to see if a clinical decision support tool could reduce presumptive treatment of pharyngitis in children.
Methods: TEREM Emergency Medical Centers is a system of urgent care centers located throughout Israel. All clinical visits are documented and managed through a proprietary electronic medical record system called PARPAR. This system was programmed on December 7, 2013 to question the physician prior to discharge if immediate antibiotics were prescribed and to remind the physician that the likelihood of positivity on throat culture was small. Percentage of presumptive treatment of pharyngitis was measured before and after the intervention.
Results: Within days of the intervention, percentage of presumptive treatment decreased from 50-60% to 20-30%.
Discussion: A clinical decision support system markedly decreased presumptive antibiotic use. Similar interventions should be considered for changing physician behavior.
