Table 4.
Influence of intervention on antibiotic prescription.
| Reference, Country | Median (IQR) or Mean age ± SD ¥ | Intervention | Inclusion | N intervention total, % AB | N controls total, % AB |
|---|---|---|---|---|---|
| FEVER IN GENERAL | |||||
| Aronson et al. (21), US | 46 days (37–53) | CPG recommending ceftriaxone compared to no CPG | Fever | 306, 64.1%∧ | 1.304, 11.7%∧ |
| 45 days (37–53) | |||||
| CPG recommending against ceftriaxone compared to no CPG | 313, 10.9%∧ | 1.304, 11.7%∧ | |||
| Jain et al. (41), US | NR | Physician feedback through scorecards | Fever | 8.961, 10.8% | 1.0114, 12% |
| Lacroix et al. (46), France | 3.4 months (1.5–10.4) | Lab Score | FWS | 131, 41.2% | 140, 42.1% |
| 4.8 months (1.7–10.4) | |||||
| Manzano et al. (49), Canada | 12 ± 8 months° | PCT testing | Fever | 192, 25% | 192, 28% |
| 12 ± 8 months° | |||||
| Murray et al. (53), US | 36 days ± 13.8 | Implementation of a clinical pathway | Fever | 296, 69% | 224, 72% |
| de Vos-Kerkhof et al. (68), Netherlands | 1.7 years (0.8–3.9) | Clinical decision model | Fever | 219, 35.6% | 220, 41.8% |
| 2.0 years (1.0–4.2) | |||||
| (SUSPICION OF) BACTERIAL INFECTIONS | |||||
| Nelson et al. (54), US * | 2.8 years (4.4) | Antibiotic prescription rate before and after CXR result | Pneumonia | 1610, 23% | 1610, 7% |
| de Vos-Kerkhof et al. (68), Netherlands | 1.8 (0.9–4.1) | Clinical decision model | Fever and SBI | 192, 22.9% | 192, 27.1% |
| Waddle and Jhaveri (69), US | 17 months ± 11° | PCV7 | FWS and BC | 275, 57.2% | 148, 60.8% |
| 15 months ± 10° | |||||
| INFLUENZA | |||||
| Blaschke 2014 (25), US◇ | 53% < 18 years | Rapid viral testing (positive/negative RVT) | RVT performed | NR, 11% | NR, 47% |
| Benito-Fernández et al. (24), Spain | 6.86 months ± 6.3° | Rapid viral testing (positive/negative RVT) | Fever without source | 84, 0% | 122, 38.5% |
| 6.55 months ± 6.8° | |||||
| Bonner et al. (27), US | NR | Rapid viral testing (RVT /no RVT) | Influenza positive | 96, 7% | 106, 25% |
| Doan et al. (33), Canada | 15 months (3–36) | Rapid viral testing (POCT/standard testing) | Acute respiratory symptoms | 89, 18% | 110, 21% |
| 14 months (4–34) | |||||
| Iyer et al. (40), US | ±75% 6–24 months | Rapid viral testing (RVT/ no RVT) | Fever | 345, 25.3% | 355, 30.5% |
| Li-Kim-Moy et al. (48), Australia | 3.1 years (1.1–7.4) | Rapid viral testing (POCT/standard testing) | Lab proven influenza | 236, 33% | 65, 54% |
| Özkaya et al. (58), Turkey | 5.7 years ± 3.4° | Rapid viral testing (RVT /no RVT) | Influenza-like illness | 50, 58% | 47, 100% |
| 4.25 years ± 2.02° | |||||
| Poehling et al. (62), US | NR | Rapid viral testing (RVT/no RVT) | Fever or ARS during influenza season | 135, 32% | 170, 29% |
| Sharma et al. (64), US | 9 months° | Rapid viral testing (RVT /no RVT) | Fever and positive influenza test | 47, 2% | 25, 24% |
| AOM | |||||
| Chao et al. (29), US | 5.01 years (3.67–6.68) | Delayed prescription with and without prescription | AOM | 100, 19% | 106, 46% |
| 3.73 years (2.82–5.75) | |||||
| Fischer et al. (34), US | 68% 2–6 years | Wait-and-see prescription in AOM | AOM | 144, 27% | N.A. |
| McCormick et al. (52), US | ±60% < 1 years | Wait-and-see prescription in AOM | AOM | 100, 34% | 109, 100% |
| Nibhanipudi et al. (55), US* | 5.72 years ± 0.38° (m) | WBC >15.000 or WBC < 15.000 | AOM | 93, 3% | 7, 100% |
| 7.41 years ± 0.75° (f) | |||||
| Spiro et al. (66), US | 3.2 years | Wait-and-see prescription in AOM | AOM | 138, 38% | 145, 87% |
| 3.6 years | |||||
| RTI Other | |||||
| Angoulvant et al. (20), France | 17 months (7–40) | Implementing guidelines | ARTI | NR, 21% | NR, 32.1% |
| Ayanruoh et al. (22), US | NR | Rapid streptococcal testing | Clinical diagnosis of pharyngitis | 6.557, 22.45% | 1.723, 41.38% |
| Linder et al. (47), US | 45% 6–11 years | GABHS testing in sore throat | Sore throat | NR, 48% | NR, 51% |
| Ouldali et al. (59), France | 1.6 years (0.7–3.6) | Implementation of national guidelines | ARTI | 134.450,−28.4% | 61.612 |
| 1.7 years (0.7–3.7) | |||||
| Spiro et al. (65), US | 17.3 months° | Tympanometry for reduction antibiotics in AOM | Fever or ARS | 341, 28.8% | 340, 26.8% |
| 17.2 months° | |||||
| Wheeler et al. (70), US | 3 years (1 months−20 years) | Videotape in waiting room | Viral infections | 71, 4.2% | 73, 6.8% |
∧
Only parenteral antibiotic prescription rate is given. Highlighted studies indicate studies with significant results.
*
Estimated/calculated from numbers in article.
°
Mean age given, median age not reported.