Table 2 Characteristics of patients who were prescribed antibiotics but should not have been according to guidelines
Age range (years) | Site | Reason(s) for visit | McIsaac scorea | Antibiotic prescribed | Notes, including quotations from provider documentation |
|---|---|---|---|---|---|
3–5 | ED | Abdominal pain, fever, congestion | 3–4 | Amoxicillin | Provider mentions negative RADT and pending culture. No comment on negative culture result in chart. |
3–5 | ED | Rash, throat pain, rhinorrhea | 2–4 | Amoxicillin | “Given that patient is otherwise classic for a scarlet fever rash, will treat with amoxicillin…” |
6–8 | Clinic | Sore throat, fever, rhinorrhea, cough | 3–4 | Amoxicillin | Diagnosis in note is “viral infection”. Antibiotic was prescribed by a different provider than the one who wrote the note. |
6–8 | Clinic | Sore throat, fever | 3–4 | Amoxicillin | “Will treat… in view of impressive exam.” Upon receipt of negative throat culture result: “Throat [culture] neg[ative]. Will leave on [antibiotics] for probable tonsillitis.” |
12–14 | Clinic | Headache, vomiting, sore throat | 3–4 | Amoxicillin | “Could be viral given negative rapid strep, but symptoms are classic, so will treat presumptively…” |
12–14 | ED | Sore throat, fever, voice change, trismus, snoring | 5 | Ampicillin-sulbactam, amoxicillin-clavulanate | Diagnosed with tonsillitis, admitted to hospital. Heterophile antibody test negative. Recently treated with clindamycin for GAS-negative tonsillitis. |
12–14 | ED | Throat pain, ear pain, fever, rhinorrhea, epigastric pain | 3 | Clindamycin | Heterophile antibody test positive. |
12–14 | ED | Throat pain, fever, ear pain | 4–5 | Amoxicillin | “Rapid strep negative though Centor score would suggest high probability… Will treat empirically for strep pharyngitis.” |