Pediatric Infectious Diseases

Antimicrobial Stewardship

The Centers for Disease Control and Prevention (CDC) estimate that of nearly 154 million outpatient antibiotic prescription (OAPs) issued each year, approximately 30% are unnecessary. The CDC further estimates that the remaining 70% of OAP patients may benefit from improvement in antibiotic selection. To that end, the Cleveland Clinic Antimicrobial Stewardship committee, in collaboration with the Office of Clinical Compliance, has begun tracking OAP selection for 4 common diagnoses: otitis media, pharyngitis, sinusitis, and urinary tract infection. This report evaluates the encounter diagnostic code and whether the OAP selected is concordant with clinical practice guidelines,1 and includes considerations for penicillin allergy, if documented. The report does not consider microbiologic data, additional antibiotic allergies, previous treatment failures, or other patient-specific factors.

Guideline Consistent Antibiotic Selection by Diagnosis


ᵃNo national estimate for urinary tract inefctions is available.

  1. Hersh AL, Fleming-Dutra KE, Shapiro DJ, Hyun DY, Hicks LA; for the Outpatient Antibiotic Use Target-Setting Workgroup. Frequency of first-line antibiotic selection among US ambulatory care visits for otitis media, sinusitis, and pharyngitis. _JAMA Intern Med. _2016;176(12):1870–1872