Journal of Urgent Care Medicine

Encouraging Trends Found in Recent UTI Prescribing Practices

Researchers from Boston Children’s Hospital analyzed US emergency department visits for pediatric urinary tract infections (UTIs) to uncover trends in antibiotic prescribing practices. As reported by CIDRAP, from 2011 to 2020, use of trimethoprim-sulfamethoxazole for pediatric UTIs prescriptions declined from 20.6% to 9.9% of visits—which was considered encouraging against concerns for increasing drug resistance—and the use of enteral first-generation cephalosporins increased from 15.2% to 32.6% of visits. Meanwhile, use of enteral third-generation cephalosporins remained flat. …

New Antibiotic Approved for UTIs

The Food and Drug Administration (FDA) announced the approval of the oral antibiotic pivmecillinam for treating uncomplicated urinary tract infections (UTIs) in women over age 18. Marketed as Pivya, pivmecillinam has a unique mechanism of action to treat UTIs caused by susceptible isolates of Escherichia coli, Proteus mirabilis and Staphylococcus saprophyticus. It’s been in use outside of the United States for decades, but it’s the first antibiotic for UTIs approved by FDA in 20 years. …

Abstracts in Urgent Care – May 2024

Encouraging Shorter Course Antibiotic Prescribing Take Home Point: In this quality improvement project, both education with performance feedback in combination with clinical decision support (CDS) were effective in modifying clinician behavior surrounding antibiotic prescribing. Citation: Vernacchio L, Hatoun J, Patane L, et al. Improving Short Course Treatment of Pediatric Infections: A Randomized Quality Improvement Trial. Pediatrics.2024;153(2): e2023063691 Relevance: There is increasing evidence that shorter courses of antibiotics for the treatment of pediatric pneumonias (CAP) and …

Negative RADT and Bacterial Growth on Throat Culture

Kristin Hrabowy, DO; Jenna Santiago-Wickey, DO; Brianna Promutico, DO; Godwin Dogbey, PhD; and Elizabeth Gignac, DO, FACOEP Urgent message: “Sore throat” is among the most common presenting complaints in the urgent care setting. Accurate diagnosis—including appropriate use of diagnostic tools—is essential to ensure timely, appropriate treatment, including appropriate utilization of antibiotic agents to minimize risk for antibiotic resistance. Citation: Hrabowy K, Santiago-Wickey J, Promutico B, Dogbey B, Gignac E. Negative RADT and bacterial growth on …

FDA Tools Up to Help Providers Fight Resistance and Get Timelier Antibiotic Updates

The Food and Drug Administration unveiled a new tool designed to give urgent care physicians and other providers more timely access to updates on antibiotics and antifungal drugs this week. The overarching aim is to help clinicians anticipate when bacterial or fungal infections are likely to respond to a specific drug. Under the new approach, FDA can simultaneously update the breakpoints for multiple drugs that have the same active ingredient and share that information transparently …

Data Quantify Value of Physician Ed in Reducing Antibiotic Prescriptions

Kaiser Permanente in Southern California reports that using computer alerts to inform physicians when antibiotics may not be the best course of treatment for sinusitis reduced the chance of an antibiotic being prescribed—with some qualifiers. The study, published recently in the American Journal of Managed Care, tracked nearly 22,000 cases of acute sinusitis in adults in primary care and urgent care offices. Researchers found that clinical decision support was associated with a 22% decrease in …

Your Antibiotic Stewardship Efforts Are Paying Off

A new study by the Blue Cross Blue Shield Association indicates that efforts to curb inappropriate antibiotics prescribing are working. The project considered 173 million claims reflecting the care of subscribers <65 years of age who filled antibiotic prescriptions between 2010 and 2016, finding that prescriptions for antibiotics fell 22% for infants, 16% for children, and 6% for adults during that time frame. Patients in the South and Appalachia were more likely to fill prescriptions …

CDC Update on Antibiotics Embraces Role of Urgent Care

The Centers for Disease Control and Prevention’s 2017 report Antibiotic Use in the United States: Progress and Opportunities embraces urgent care as an active participant in both healthcare delivery and antibiotic stewardship more than ever before. The CDC notes that urgent care has experienced “tremendous growth” and that continuing to incorporate antibiotic stewardship as a core value “will be an important factor in optimizing antibiotic use.” To support those efforts, the CDC put together The …

A Multimodal Intervention to Reduce Antibiotic Use for Common Upper Respiratory Infections in the Urgent Care Setting

Urgent message: Upper respiratory infections (URIs) are the most common presenting complaint in urgent care. Regardless of etiology or provider specialty, antibiotics are prescribed 60% of the time for the treatment of URIs, contributing to drug-resistant respiratory organisms. Employing a multimodal intervention, the authors we were able to appreciate a modest, statistically significant decrease in the rate of antibiotic prescribing among urgent care providers. Introduction Antimicrobial resistance is arguably one of the greatest risks to …

Urgent Care is One Focus of New CMS Antibiotic Stewardship Initiative

As antibiotic resistance continues to grow, organizations from the Urgent Care Association of America to the Antibiotic Resistance Action Center to the Centers for Disease Control and Prevention have asked their audiences to take a close look at what they can do to curb unnecessary prescriptions that exacerbate the problem. (The cover article in the May issue of JUCM will look at how one institution tackled this problem, as well.) Now the Centers for Medicare …

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