High Priority Status: Yes; Appropriate Use
NQF Number: N/A
Percentage of patients age 6 months to 12 years of age at the time of the visit with a current diagnosis of an uncomplicated acute tympanostomy tube otorrhea (TTO) who were prescribed or recommended to use topical antibiotic eardrops and NOT prescribed systemic (IV or PO) antibiotics for acute TTO.
Denominator:
All patients age 6 months through 12 years of age at the time of the visit with a current diagnosis of an uncomplicated* acute** TTO
* Uncomplicated refers to TTO that is not accompanied by high fever (38.5°C, 101.3°F), concurrent illness requiring systemic antibiotics (e.g., streptococcal pharyngitis, bacterial sinusitis), or cellulitis extending beyond the external ear canal to involve the pinna or adjacent skin.
** Acute refers to less than four weeks’ duration.
Denominator Exclusions:
None
Denominator Exceptions:
Medical reason(s) for not prescribing/recommending topical antibiotic monotherapy or for prescribing oral antibiotics include:
- Patients with high fever;
- Patients with cellulitis of the ear or adjacent skin;
- Patients who are immunocompromised;
- Patients with oral antibiotic given for other concurrent condition including but not limited to streptococcal pharyngitis, bacterial sinusitis, pneumonia, pharyngitis, osteitis abscess, or other concurrent acute infection beyond the confines of the ear canal;
- Patients who failed topical antibiotic therapy;
- Patients with a cochlear implant;
- Patients with concurrent diabetes;
- Patients who were prescribed oral antibiotics by another clinician; concurrent diagnosis of acute suppurative otitis media with effusion with intact eardrum; acute TTO persists, or worsens, despite topical antibiotic therapy.
Patient reason(s) for not prescribing/recommending topical antibiotics or prescribing oral antibiotics include:
- Administration of eardrops is not possible because of local discomfort;
- Lack of tolerance.
Numerator:
Patients who were prescribed or recommended to use topical antibiotic eardrops and NOT prescribed systemic (IV or PO) antibiotics for acute TTO.
Numerator Exclusions:
None
Measure Classifications:
- Measure Type: Process
- National Quality Strategy (NQS) domain: Effective Clinical Care
- Meaningful Measures Area: Appropriate Use of Healthcare
- Care Setting(s): Ambulatory Care: Clinician Office/Clinic
- Includes Telehealth: Yes
- Number of Performance Rates: 1
- Inverse measure: No
- Continuous measure: No
- Proportional measure: Yes
- Ratio measure: No
- Risk-adjusted measure: No
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