1120. Reliability of Parent-Reported Pediatric Antibiotic Use in a Longitudinal Birth Cohort

BACKGROUND: Depending on the population of interest, it is not always feasible to acquire electronic health record (EHR) data for antibiotic prescribing in longitudinal outpatient studies. Even when available, EHR algorithms are limited to only capturing in-network prescriptions. Thus, there is value in learning more about the reliability of parent-reported data to see whether this approach can be validated for epidemiologic research. METHODS: We examined antibiotic prescribing in the MAGIC (Microbiome, Antibiotics, and Growth Infant Cohort) Study, a longitudinal birth cohort of healthy newborns followed through 2 years of life. An informatics algorithm within an EHR platform was developed such that the study team received a text message alert every time a study participant who sought care in the Children’s Hospital of Philadelphia (CHOP) Care Network was prescribed an antibiotic. Families were also asked every 3 months whether their child had been prescribed an antibiotic in the past 3 months. We compared parent-reported antibiotic use with antibiotic use that generated an alert in the EHR. RESULTS: Among the 104 EHR-documented antibiotic exposures in 3-month spans, 52 (50%) were reported by parents at the relevant time point. Of the 52 nonreported antibiotic prescriptions that generated alerts, 4 (4%) were explicitly not reported by families and the remaining 48 exposures (46%) were not reported because the family did not answer the question at the relevant time point. There were 11 total exposures that were patient-reported without documented EHR alerts. CONCLUSION: In this longitudinal birth cohort, only half of in-network, EHR-generated alerts for antibiotic prescriptions were reported by parents, and parent-reported antibiotic exposures occurred outside of the pediatric network that, by definition, could not generate EHR-based alerts. These results suggest that the most effective method for quantifying antibiotic use may be using EHR data supplemented with parent-reported data. DISCLOSURES: All authors: No reported disclosures.