Digital Tool Cuts Antibiotic Prescribing

Pragmatic trial finds digital decision support reduces antibiotic use in Rwandan health centers

By
Jess Allerton
March 6, 2026
2 min

Conexiant

Overview

A digital clinical decision support algorithm significantly reduced antibiotic prescribing in pediatric outpatient settings in Rwanda, with prescriptions dropping from approximately 71% to 25%. The study demonstrated that reduced antibiotic use did not compromise clinical recovery outcomes for children.

Background

Inappropriate antibiotic use is a major contributor to antimicrobial resistance, particularly in low-resource settings where diagnostic capabilities are limited. This study addresses the critical need for improved antibiotic stewardship in pediatric outpatient care, aiming to align prescribing practices with established guidelines. The integration of digital tools in clinical settings may enhance adherence to these guidelines and improve patient outcomes.

Data Highlights

Outcome	Standard Care	Digital Tool (ePOCT+)
Antibiotic Prescribing Rate	~71%	~25%
Clinical Recovery Outcomes	Similar	Similar

Key Findings

The ePOCT+ algorithm guided clinicians through structured assessments and point-of-care tests.
Antibiotic prescriptions fell from approximately 71% to 25% in facilities using the digital tool.
Clinical recovery outcomes remained similar between the intervention and control groups.
The study was conducted across 32 public health centers in Rwanda, involving nearly 60,000 pediatric consultations.
Non-randomized design may limit causal conclusions but reflects real-world implementation.

Clinical Implications

Healthcare providers in pediatric outpatient settings should consider integrating digital clinical decision support tools to enhance antibiotic stewardship. This approach may lead to significant reductions in unnecessary antibiotic prescriptions without negatively impacting patient recovery.

Conclusion

The findings suggest that digital clinical decision support can effectively improve antibiotic prescribing practices in pediatric care, highlighting the potential for broader implementation in similar healthcare settings. Further research is warranted to evaluate long-term impacts on antimicrobial resistance.