Journal of Urgent Care Medicine

Which Children Receive First-Line Antibiotics in Urgent Care Most Often?

In a new study of children 6 to 18 months of age, researchers found the odds of receiving first-line antibiotic therapy in pediatric urgent care centers (PUCs) were lower among White children and those with commercial insurance than in other groups. Authors of the study presented in Infection Control & Hospital Epidemiology looked at guideline-recommended first-line antibiotics for acute respiratory infections (ARIs) for 396,340 encounters at 28 PUCs in the United States over 1 year. …

Amoxicillin-Clavulanate Shows Slightly More Risk of Issues Than Amoxicillin

In a study of 320,141 children published in JAMA Network, researchers found those treated with amoxicillin-clavulanate had a slightly higher risk of treatment failure (defined as lack of effectiveness or intolerability) compared with amoxicillin. And for those treated with amoxicillin-clavulanate, there was also a higher risk of gastrointestinal symptoms and yeast infections. Accessing treatment in urgent care was more common among patients who received amoxicillin-clavulanate (9.6%) than those who received amoxicillin (5.9%), and urgent care …

Why Patients Self-Medicate With Leftover Antibiotics

Researchers surveyed adult patients in the waiting rooms of 6 public, safety-net primary care clinics and 2 private emergency departments in Texas and found that more than half of the respondents said they would use leftover antibiotics if they were feeling sick. Among the 546 volunteering patients surveyed, the most common situations that would inspire patients to use non-prescription antibiotics were having access to leftover antibiotics (50.4%), experiencing symptom improvement with prior use of antibiotics …

Program Increases Appropriate Antibiotics for Pediatric Infections

A national quality improvement (QI) initiative resulted in increases in appropriate antibiotic prescribing for pediatric infections at 118 US hospitals, as published in Pediatrics. The QI program sought to encourage the use of appropriate antibiotic therapy for community-acquired pneumonia, skin and other soft-tissue infection, and urinary tract infection. Program actions included monthly feedback, education, coaching, order sets, and a mobile app with treatment recommendations. Overall, adherence to empirical antibiotic therapy was 72%; definitive antibiotic therapy …

Sniffling Leads to Sneaking a Dose of Leftover Antibiotics

Individuals are obtaining antibiotics that were not prescribed for them from a variety of sources—including other countries, the internet, friends, relatives, or from previous prescriptions—and using them to self-treat their cold and flu symptoms, according to a press release from the Infectious Diseases Society of America. Convenience, past treatment experiences, and the hassle of navigating the healthcare system are among the reasons patients said they take the “nonprescription” antibiotics. The study was presented by the Baylor College …

Differentiating Acute Conjunctivitis Presentations in Children

Urgent message: Make the distinction between viral and bacterial conjunctivitis to ensure children receive appropriate treatment and to avoid the negative consequences of antibiotic overuse. Julian P. Ponsetto MD, Momoko K. Ponsetto MD Download the article PDF Here Citation: Ponsetto JP, Ponsetto MK. Differentiating acute conjunctivitis presentations in children. J Urgent Care Med. 2023;17(11):15-20. Infectious conjunctivitis or “pink eye” is common in the pediatric population, accounting for 2.7% of diagnoses in pediatric urgent care.1 However, …

Abstracts in Urgent Care – October 2023

Which Sample is More Accurate for STIs: Vaginal or Urine? Take Home Point: Vaginal swabs are the optimal sample type for women being evaluated for chlamydia, gonorrhea, and/or trichomoniasis. Citation: Aaron K, Griner S, Footman A, et. al. Vaginal Swab vs Urine for Detection of Chlamydia trachomatis, Neisseria gonorrhoeae, and Trichomonas vaginalis: A Meta-Analysis Ann Fam Med. 2023 Mar-Apr;21(2):172-179. doi: 10.1370/afm.2942 Relevance: Many sexually transmitted infections (STI) are asymptomatic in women and can have serious …

Abstracts in Urgent Care – September 2023

How Long Should We Prescribe Antibiotics for Pediatric UTI? Take-Home Point: Children receiving 5 days of antibiotics for urinary tract infection (UTI) had a higher rate of treatment failure that children receiving 10-day courses. However, absolute treatment failure rates were low in both groups. Citation: Zaoutis T, Shaikh N, Fisher B, et. al. Short-Course Therapy for Urinary Tract Infections in Children: The SCOUT Randomized Clinical Trial. JAMA Pediatr. 2023 Jun 26; e231979. Relevance: There have …

Abstracts in Urgent Care – February 2023

Ivan Koay MBChB, MRCS, FRNZCUC, MD Quinolone Eardrops and Achilles Tendon-Related Outcomes Take-home point: Quinolone eardrops were associated with an increased risk of all-type tendon rupture, including Achilles tendon (AT), but not AT tendinitis. Citation: Tran P, Antonelli P and Winterstein A. Quinolone ear drops and Achilles tendon rupture. Clin Infect Dis. 2022; ciac709. Epub ahead of print September 6, 2022. Relevance: Systemic quinolones have been known to increase the risk of tendon rupture. Prior …

Abstracts in Urgent Care – June 2022

Maximizing the Value of Urine Dipstick Testing Screening for Intimate Partner Violence Antibiotics for Children with RTI Azithromycin in Pediatric Viral Infection Self-Monitoring BP with Unvalidated Devices Modified Valsalva Maneuver in SVT To Mix or Not to Mix COVID-19 Vaccines? Ivan Koay, MBChB, FRNZCUC, MD Nitrofurantoin Resistance Take-home point: Proteeae group bacteria, which are often resistant to nitrofurantoin, normally result in alkaline (ie, high pH) urine on dipstick testing. Citation: Sheele J, Libertin C, Fink …

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