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PEDIATRICS Vol. 107 No. 2 February 2001, p. e15

ELECTRONIC ARTICLE:
A Randomized Controlled Trial of Point-of-Care Evidence to Improve the Antibiotic Prescribing Practices for Otitis Media in Children

Received Jul 18, 2000; accepted Sep 19, 2000.

Dimitri A. Christakis*, Dagger , parallel , Frederick J. Zimmerman*, parallel , Jeffrey A. Wright*, Dagger , Michelle M. Garrison*, Dagger , Frederick P. Rivara*, Dagger , §, and Robert L. Davis*, Dagger , §

From the * Child Health Institute and the Departments of Dagger  Pediatrics, § Epidemiology, and parallel  Health Services, University of Washington, Seattle, Washington.

Context.  Prescribing practices for otitis media are not consistent with current evidence-based recommendations.

Objective.  To determine whether point-of-care evidence delivery regarding the use and duration of antibiotics for otitis media decreases the duration of therapy from 10 days and decreases the frequency of prescriptions written.

Design.  Randomized, controlled trial.

Setting.  Primary care pediatric clinic affiliated with university training program.

Intervention.  A point-of-care evidence-based message system presenting real time evidence to providers based on their prescribing practice for otitis media.

Main Outcome Measures.  Proportion of prescriptions for otitis media that were for <10 days and frequency with which antibiotics were prescribed.

Results.  Intervention providers had a 34% greater reduction in the proportion of time they prescribed antibiotics for <10 days. Intervention providers were less likely to prescribe antibiotics than were control providers.

Conclusions.  A point-of-care information system integrated into outpatient pediatric care can significantly influence provider behavior for a common condition.  Key words:  evidence-based medicine, antibiotics, otitis media, informatics, prescriptions.


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