Available Guidelines Are All You Need to Improve Antibiotic Stewardship—and Save Lives

Suggestions that urgent care was any more responsible for overuse of antibiotics—and subsequent drug resistance—than other practice settings were largely blown out of proportion. For one thing, patients self-select urgent care over other settings when it seems evident that an antibiotic is needed, so it’s likely that urgent care providers see more patients who really do need a prescription. Clearly there are instances where one is given even though it’s not indicated, as well. As an industry, urgent care got the message and started corrective action to cut down on inappropriate antibiotic prescribing and reduce risk for potentially deadly resistance. Antibiotic stewardship became a priority, and the benefits are already starting to be realized. Intermountain Healthcare in Salt Lake City, Utah, for one, opted to focus its providers’ collective attention on the Core Elements of Antibiotic Stewardship devised by the Centers for Disease Control and Prevention. The company put together a stewardship program based on the CDC guidance and tracked its impact between July 2019 and June of this year. It included educational messaging for providers and patients alike, media campaigns, electronic health record tools, and a clinician prescribing dashboard. According to results Intermountain presented at ID Week 2020, after evaluating 1,559,403 urgent care encounters the number of patients with respiratory conditions that received an antibiotic prescription declined from 49.9% pre-intervention to 35.3% during the intervention. In addition, recommendation of first-line therapy increased while prescribing for conditions where antibiotics are not indicated decreased. Overall, antibiotic prescribing fell 20%.  Access the Core Elements of Antibiotic Stewardship here, and consider how you might best remind providers in your organization that urgent care is in a position to lead the way to more responsible antibiotic prescribing.