Supplemental Information

ARTICLE

PEDIATRICS Volume 146, Number 3, September 2020 1 SUPPLEMANTAL FIGURE 3 Example individualized antibiotic prescribing feedback report used in the DART study. Amox, amoxicillin; Clav, clavulanate; Rx, prescription.

2 ARTICLE

SUPPLEMANTAL FIGURE 4 aRR for antibiotic prescribing from ITT analyses of the DART primary and secondary outcomes by study phase.

PEDIATRICS Volume 146, Number 3, September 2020 3 SUPPLEMANTAL TABLE 5 ICD-10 Codes Used To Define ARTI Visits Diagnosis Included Conditions ICD-10 Codesa AOM Acute serous, allergic, and H65.0n, H65.11n, H65.19n, H65.2n, nonsuppurative otitis media; chronic H65.3n, H65.41n, H65.49n, H65.9n, serous, mucoid, allergic, and H66.00n, H66.01n, H66.1n, H66.2n, nonsuppurative otitis media H66.3Xn, H66.4n, H66.9n, and/or H67.n Pharyngitis Acute pharyngitis and tonsillitis J02, J02.n, J03, J03.00, J03.8n, and/or J03.9n Sinusitis Acute maxillary, frontal, ethmoidal, J01.0n, J01.1n, J01.2n, J01.3n, J01.4n, sphenoidal, and pansinusitis J01.8n, and/or J01.9n Viral ARTIsb Common cold, upper respiratory tract J00, J06.n, J10.1, J11.1, J20.3-J20.9, infection, influenza, bronchitis, and J21.n, and/or J40 bronchiolitis Additional Central venous catheter infections, T80.2n, T88.0n, W50.3n, W53.n1Xn, bacterial infection after immunization, bites and W54.0XXn, W55.n1Xn, W56.n1Xn, infectionsc scratches, infections due to specific W58.n1Xn, W59.n1Xn, W61.n1xn, pathogens (eg, Salmonella), sexually Y04.1xxn, A01.0n, A01.n, A02.n, A03.n, transmitted diseases, neutropenia, A04.n, A18.0n, A22.7, A23.n, A26-27.n, cellulitis, abscess, otitis externa, A28.0, A28.2-9, A32.n, A33, A37.n, chronic otitis media, pneumonia, A38.1-9, A40-41.n, A42.7, A48-59.n, chronic sinusitis, impetigo, A63.8, A64, A69.2n, A74.8-9n, B37.7, lymphangitis, lymphadenitis, acne and B78.1, B95.n, B96.n, D70.n, H00.036, other skin conditions, septic arthritis, H05.01n, H60.0-3n, H62.4n, H66.1-3n, osteomyelitis and discitis, myositis, I00, I01.n, J13-8.n, J20.0-2, J32.n, J36, pyelonephritis, cystitis, urinary tract J39.0-1, K04.0, K04.4, K04.6-7, K12.2, infection, salpingitis, peritonitis, pelvic K61.n, L01-8.n except L03.213 and infections, sepsis, and bacteremia L08.1, L70.n, L73.0, L88, L92.8, L98.0, L98.3, M00-1.n, M46.2-3n, M60.0n, M86.n, N11.0-1, 13N.6, N15.1, N15.9, N16, N30.n, N34.0-2, N39.0, N70.n, N71-7.n, N98.0, P36-9.n, R65.n, and/ or R78.81 a An “n” within or at the end of a code (eg, H65.0n) denotes that any ICD-10 code with any numeral or letter in that position is included. b Excludes codes in which bacterial pathogens are noted (eg, Mycoplasma). c These were used to exclude visits from being categorized as viral in the analysis.

SUPPLEMANTAL TABLE 6 ARTI Visits and Unadjusted Antibiotic Prescribing Rates by Study Time Period Characteristic Baseline Module 1 Module 2 Module 3 Postintervention Total No. all ARTI 42 191 6287 7319 8166 8760 72 723 Received antibiotics, n 17 183 2515 2594 3022 3444 (39.3) 28 758 (%) (40.7) (40.0) (35.4) (37.0) (39.5) No. all pharyngitis 12 206 2130 2023 1765 2340 20 464 Received antibiotics, n 5394 987 785 691 1024 (43.8) 8881 (%) (44.2) (46.3) (38.8) (39.2) (43.4) No. viral ARTI 19 442 2760 3633 4265 4224 34 324 Received antibiotics, n 1234 (6.3) 143 (5.2) 146 (4.0) 195 (4.6) 224 (5.3) 1942 (%) (5.7) No. streptococcal 4307 774 618 567 840 7106 pharyngitis Received second-line 566 (13.1) 61 (7.9) 66 (10.7) 38 (6.7) 60 (7.1) 791 antibiotics, n (%) (11.1) No. AOM 7470 997 1131 1530 1684 12 812 Received second-line 2055 264 252 427 413 (24.5) 3411 antibiotics, n (%) (27.5) (26.5) (22.3) (27.9) (26.6) No. sinusitis 3103 370 532 606 512 5123 Received second-line 575 (18.5) 55 (14.9) 54 (10.2) 75 (12.4) 61 (11.9) 820 antibiotics, n (%) (16.0)