Mannix Mary Kathryn, Polischuk Emily, Islam Shamim
Department of Pediatrics (MKM), Division of Pediatric Infectious Diseases, University at Buffalo Jacobs School of Medicine and Biomedical Sciences, Buffalo, NY.
Department of Pharmacy (EP), John R. Oishei Children's Hospital, Buffalo, NY.
J Pediatr Pharmacol Ther. 2022;27(3):228-231. doi: 10.5863/1551-6776-27.3.228. Epub 2022 Mar 21.
Antibiotics are the most common class of medication prescribed in pediatrics, with the majority of prescriptions occurring in the outpatient setting. Our objective was to evaluate the accuracy of antibiotic dose, frequency, and formulation prescribed for urinary tract infections (UTIs) in the pediatric ambulatory care setting.
This was a retrospective review of electronic medical records conducted at 2 suburban pediatric practices in a mid-sized metropolitan region. Encounter-related prescriptions were identified using UTI-associated International Classification of Diseases, 10th Revision codes. Patients aged 2 months through 18 years were included if they had been prescribed an oral antibiotic for the treatment of UTI. Antibiotic dose, frequency, and formulation were considered accurate if consistent with clinical guidelines and tertiary dosing references.
Nearly 1 in 4 prescriptions had dosing inaccuracies. The proportion of errors was highest with amoxicillin-clavulanate (75%; 9/12) and amoxicillin (52%; 33/64). The most common reasons for dosing incorrectly were "low dose" or "unnecessarily high dose." Additionally, 55% of the included prescriptions were for oral suspensions, and 1 in 4 of these were dosed incorrectly.
Inaccuracies in antibiotic prescribing for pediatric UTI are common, including for frequently prescribed agents and oral formulations. To address these missed opportunities for stewardship in the outpatient setting, key educational sessions with providers should include reviewing optimal antibiotic dosing for uropathogens and highlighting common errors when oral suspensions are prescribed.
抗生素是儿科最常用的一类药物，大多数处方是在门诊开具的。我们的目的是评估儿科门诊护理环境中为治疗尿路感染（UTI）所开抗生素的剂量、频率和剂型的准确性。
这是一项对位于一个中等规模大都市地区的两家郊区儿科诊所的电子病历进行的回顾性研究。使用与UTI相关的国际疾病分类第十版编码来识别与就诊相关的处方。年龄在2个月至18岁之间、因UTI而开具口服抗生素治疗的患者被纳入研究。如果抗生素剂量、频率和剂型与临床指南及三级剂量参考一致，则认为是准确的。
近四分之一的处方存在剂量不准确的情况。阿莫西林 - 克拉维酸（75%；9/12）和阿莫西林（52%；33/64）的错误比例最高。剂量错误的最常见原因是“低剂量”或“不必要的高剂量”。此外，纳入研究的处方中有55%是口服混悬剂，其中四分之一的剂量有误。
儿科UTI抗生素处方不准确的情况很常见，包括常用药物和口服剂型。为了解决门诊环境中这些管理上的疏漏，与医疗服务提供者开展的关键教育课程应包括复习针对尿路病原体的最佳抗生素剂量，并强调开具口服混悬剂时的常见错误。
