Holly M Frost1, Thresia Sebastian2, Josh Durfee3, Timothy C Jenkins4. 1. Department of Pediatrics, Denver Health and Hospital Authority, Denver, Colorado; University of Colorado School of Medicine, Aurora, Colorado; Office of Research, Denver Health and Hospital Authority, Denver, Colorado. Electronic address: Holly.Frost@dhha.org. 2. Department of Pediatrics, Denver Health and Hospital Authority, Denver, Colorado; University of Colorado School of Medicine, Aurora, Colorado. 3. Office of Research, Denver Health and Hospital Authority, Denver, Colorado. 4. University of Colorado School of Medicine, Aurora, Colorado; Division of Infectious Diseases and Department of Medicine, Denver Health and Hospital Authority, Denver, Colorado.
Abstract
BACKGROUND: Infectious conjunctivitis is among the most common pediatric infections worldwide; antibiotics are often not indicated. We aimed to determine factors associated with ophthalmic antibiotic prescribing and changes in prescribing prior to and during the COVID-19 pandemic at a single center. METHODS: Encounters for children with infectious conjunctivitis from 2017 to 2020 at Denver Health and Hospital Authority clinics were analyzed retrospectively. Factors associated with prescribing were evaluated using multivariable logistic regression modeling. Encounter numbers and prescribing patterns for telephone versus in-person visits before and during the pandemic were compared and stratified. RESULTS: Of 5,283 patients encounters for conjunctivitis, 3,841 (72.7%) resulted in an ophthalmic antibiotic prescription. Concurrent diagnosis with acute otitis media (adjusted odds ratio [aOR] 0.20 (95% CI, 0.16-0.25) and later study year (2018-aOR = 0.76 [95% CI, 0.65-0.89]; 2019- aOR = 0.57 [95% CI, 0.48-0.67]) were associated with reduced odds of prescribing. Compared with those evaluated in pediatric clinics, patients evaluated in family medicine (aOR = 0.69 [95% CI, 0.58-0.83]) or optometry/ophthalmology clinics (aOR = 0.06 [95% CI, 0.02-0.14]) were less likely to have antibiotics prescribed, whereas, patients evaluated via telephone had a 5.43 (95% CI, 3.97-7.42) greater odds of being prescribed ophthalmic antibiotics. Antibiotic prescribing increased from 67.8% prior to the COVID-19 pandemic to 81.9% during the pandemic (P < 0.0001). CONCLUSIONS: Discordant with national guideline recommendations, ophthalmic antibiotic use for conjunctivitis was high. Telephone visits were associated with higher rates of prescribing. Rates of prescribing increased significantly during the COVID-19 pandemic.
BACKGROUND: Infectious conjunctivitis is among the most common pediatric infections worldwide; antibiotics are often not indicated. We aimed to determine factors associated with ophthalmic antibiotic prescribing and changes in prescribing prior to and during the COVID-19 pandemic at a single center. METHODS: Encounters for children with infectious conjunctivitis from 2017 to 2020 at Denver Health and Hospital Authority clinics were analyzed retrospectively. Factors associated with prescribing were evaluated using multivariable logistic regression modeling. Encounter numbers and prescribing patterns for telephone versus in-person visits before and during the pandemic were compared and stratified. RESULTS: Of 5,283 patients encounters for conjunctivitis, 3,841 (72.7%) resulted in an ophthalmic antibiotic prescription. Concurrent diagnosis with acute otitis media (adjusted odds ratio [aOR] 0.20 (95% CI, 0.16-0.25) and later study year (2018-aOR = 0.76 [95% CI, 0.65-0.89]; 2019- aOR = 0.57 [95% CI, 0.48-0.67]) were associated with reduced odds of prescribing. Compared with those evaluated in pediatric clinics, patients evaluated in family medicine (aOR = 0.69 [95% CI, 0.58-0.83]) or optometry/ophthalmology clinics (aOR = 0.06 [95% CI, 0.02-0.14]) were less likely to have antibiotics prescribed, whereas, patients evaluated via telephone had a 5.43 (95% CI, 3.97-7.42) greater odds of being prescribed ophthalmic antibiotics. Antibiotic prescribing increased from 67.8% prior to the COVID-19 pandemic to 81.9% during the pandemic (P < 0.0001). CONCLUSIONS: Discordant with national guideline recommendations, ophthalmic antibiotic use for conjunctivitis was high. Telephone visits were associated with higher rates of prescribing. Rates of prescribing increased significantly during the COVID-19 pandemic.
Authors: Divya M Varu; Michelle K Rhee; Esen K Akpek; Guillermo Amescua; Marjan Farid; Francisco J Garcia-Ferrer; Amy Lin; David C Musch; Francis S Mah; Steven P Dunn Journal: Ophthalmology Date: 2018-10-23 Impact factor: 12.079
Authors: Charles B Foster; Kathryn A Martinez; Camille Sabella; Gregory P Weaver; Michael B Rothberg Journal: Pediatrics Date: 2019-08-01 Impact factor: 7.124
Authors: Penny A Asbell; Kathryn A Colby; Sophie Deng; Peter McDonnell; David M Meisler; Michael B Raizman; John D Sheppard; Daniel F Sahm Journal: Am J Ophthalmol Date: 2008-03-28 Impact factor: 5.258
Authors: Luis Fernando Valladales-Restrepo; Manuel Enrique Machado-Duque; Andrés Gaviria-Mendoza; Diana Fiorella López-Caicedo; Juan Alberto Ospina-Cano; María Camila Oyuela-Gutiérrez; Dayron Fernando Martínez-Pulgarín; Jorge Enrique Machado-Alba Journal: Int Ophthalmol Date: 2022-07-01 Impact factor: 2.029