1641. Prescribing and Dispensing Delayed Antibiotics to Pediatric Patients with Acute Otitis Media and Pharyngitis
Bibliographic record
Abstract
Abstract Background Delayed antibiotic prescriptions with instructions to wait a defined period of time before filling the prescription is a strategy often used to decrease the unnecessary use of an antibiotic. Although "watchful waiting" for illnesses, such as acute otitis media (AOM) and pharyngitis, that are suspected of being viral is recommended, little is known about how often delayed antibiotics are prescribed at our institution. The primary objectives of this study were to characterize delayed prescriptions for pediatric patients with AOM or pharyngitis and to assess each prescription for adherence to guidelines. Methods Design: This study was a retrospective chart review. Pediatric patients with AOM and pharyngitis assessed and discharged from the Emergency Department (ED) between March 1, 2019 to February 28, 2021 were considered for inclusion. Data were collected from the ED Treatment Record by a trained research assistant. Setting: Our study was completed in a pediatric ED at a tertiary hospital in Canada. Exposures or interventions: Patients prescribed a delayed antibiotic on discharge from the ED. Main Outcome Measures: Frequency of delayed antibiotic prescribing, proportion of antibiotic prescriptions adherent to guidelines for empiric choice, dose, and duration. Adherence to guidelines was assessed using local guidelines and position statements by the Canadian Pediatric Society as the gold standards. Statistical analysis: Data were entered in REDCap and exported to excel for descriptive analysis. Results Delayed antibiotics were prescribed to 21.2% (332/1563) of patient encounters during the study period. Amoxicillin was the most commonly prescribed antibiotic (88.6%, 294/332). The majority of delayed prescriptions were prescribed for AOM (77.7%, 258/332). Most patients (94.8%, 309/326) received a delayed prescription for an empiric antibiotic that adhered to guidelines. Fewer prescriptions adhered to guidelines for dose (75.8 %, 247/326) and duration (73.6%, 240/326). Conclusion Most patients received the appropriate empiric antibiotic to treat AOM and pharyngitis however, dose and duration of use may be improved through antimicrobial stewardship initiatives. Disclosures Emily Black, BSc(Pharm), PharmD, Drug Evaluation Alliance of Nova Scotia: Grant/Research Support|Research Nova Scotia: Grant/Research Support
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How this classification was reachedexpand
Full frame distilled prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. Learned from the 10,348 direct Codex labels and 10,348 direct Gemma labels. Candidate is the union of thresholded teacher heads; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels or direct frontier model labels.
Codex and Gemma teacher scores by category
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.000 | 0.000 |
| Meta-epidemiology (narrow) | 0.000 | 0.000 |
| Meta-epidemiology (broad) | 0.000 | 0.000 |
| Bibliometrics | 0.000 | 0.001 |
| Science and technology studies | 0.000 | 0.000 |
| Scholarly communication | 0.000 | 0.000 |
| Open science | 0.000 | 0.000 |
| Research integrity | 0.000 | 0.000 |
| Insufficient payload (model declined to judge) | 0.000 | 0.000 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one teacher head, not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".