Abstract Background Nearly ⅓ of outpatient antibiotic prescriptions are unnecessary or inappropriate. QuizTime is a web-based application based on Test-Enhanced Learning Theory that delivers daily case-based questions to a learner’s email or cell phone. We performed a prospective cohort study to evaluate the impact of a QuizTime module on appropriateness of pediatric outpatient antibiotic prescriptions. Methods Participants received one question daily for 10 days starting in July 2022. Quiz topics included age-appropriate antibiotic duration for acute otitis media (AOM), empiric antibiotics for uncomplicated urinary tract infections (UTI), and empiric antibiotics and duration for community-acquired pneumonia (CAP) (Table 1). Participants were pediatric prescribers (physician, resident, physician assistant, nurse practitioner) in a primary care, urgent care, retail health, or emergency department setting. Antibiotic prescription data were collected during the “baseline” period (Jul 1, 2021 – Jun 30, 2022) though 3 months after QuizTime participation (Jul 15 – Oct 15 2022) defined as the “post-quiz” period. Pre- and post-intervention data were analyzed in aggregate (not at the provider-level). Significance was determined by calculating a 95% confidence interval (CI) for the difference of proportions. Outcome measures are listed in Table 1.Figure 1.Prisma diagram showing providers and oral antibiotics prescribed in each cohort. Results Eighty clinicians participated in QuizTime totaling 13,478 antibiotic prescriptions [AOM 5,613 (41.6%), UTI 668 (5.0%), CAP 225 (1.7%)] compared to 776 non-QuizTime clinicians totaling 43,321 antibiotic prescriptions [AOM 15,258 (35.2 %), UTI 2,528 (5.8%), CAP 849 (2.0%)] (Figure 1). AOM guideline-concordant antibiotic duration was significantly higher among participants than non-participants (Table 2). There were encouraging trends towards improvement in secondary outcomes (Table 3, 4). Conclusion Clinicians who participated in a QuizTime module on pediatric outpatient antibiotic prescribing showed improvement in antibiotic appropriateness suggesting web-based microlearning modules are an effective tool for disseminating antibiotic stewardship education. Creation, dissemination, and evaluation of additional QuizTime modules is ongoing. Disclosures Ritu Banerjee, MD, Ph.D, bioMerieux: Grant/Research Support|bioMerieux: company is providing partial support for an ongoing trial unrelated to submitted abstract Sophie E. Katz, MD MPH, Dolly Parton Pediatric Infectious Diseases Research Funds: Grant/Research Support|Optum: Advisor/Consultant|Pfizer: Grant/Research Support
Read full abstract