Want to Reduce Antibiotic Resistance in Children? Start with Choosing the Right Patients

Too many patients take too many antibiotics over the course of their lifetimes, often beginning from a very young age. Given the too-high incidence of multidrug resistance, this seems beyond debate. While education campaigns by the Urgent Care Association and many other provider bodies have been helpful in raising awareness, clinical evidence to help guide decision-making has been relatively sparse. One new study published by The Journal of the American Medical Association could be helpful in choosing which young patients warrant a prescription, though. Focusing on children between 2 and 11 years of age who presented with symptoms of acute sinusitis, the authors found presence of nasopharyngeal bacterial pathogens to be significant in determining whether the patient would benefit from an antibiotic (oral amoxicillin and clavulanate, in this case). Subjects with no nasopharyngeal bacterial colonization (28% of those enrolled in the study) “benefited significantly less from antibiotic treatment than children colonized with pathogens.” They further reported that the “effect of antibiotics did not differ based on the color of the nasal discharge.” While evidence should help providers decide when an antibiotic would be appropriate, there are countless other challenges in the context of urgent care medicine. Check out Antibiotic Stewardship in Pediatric Acute Otitis Media—Pearls and Pitfalls in the JUCM archive for tips on managing those.