Antimicrobial stewardship in ambulatory care!

Reviewed by Cindy Noyes, MD; University of Vermont Health, Burlington, VT

Chauhan et al. describe several simple, yet impactful, interventions to reduce unnecessary antibiotic prescriptions for respiratory infections in an academic geriatric outpatient clinic.  They deployed educational interventions for patients and providers, implemented antibiotic order sets with defined antibiotic duration by indication, and provided instructions for symptom management in the setting of a viral respiratory infection.  To control for seasonal variation, they collected data during the same date range for pre- and post-implementation analysis. The authors were able to demonstrate an almost 10% reduction in number of prescriptions overall, but more strikingly, a statistically significant reduction in duration of treatment for sinusitis, pharyngitis and otitis.  This study highlights leveraging the electronic medical record to gather antibiotic prescription data and implement interventions that promote best practices in the ambulatory setting, the next frontier for antimicrobial stewardship.  

Chauhan LR, et al (2022).  Impact of a pilot multimodal intervention to decrease antibiotic use for respiratory infections in a geriatric clinic.  Antimicrobial Stewardship and Healthcare Epidemiology,

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