Antibiotic stewardship in the outpatient setting: treating common infections in the adult population

The use and misuse of antibiotics is a major contributor to the development of antibiotic-resistant bacteria. Infections are among the most common reasons for outpatient visits, and the vast majority of antibiotic prescriptions occur in this setting. Many of these prescriptions however, are unnecessary, since they treat viral illnesses or other conditions that do not respond to antibiotics. Therefore, it is critical that clinicians practicing outpatient medicine be highly knowledgeable concerning the epidemiology, diagnosis, and management of commonly encountered infections. This quality improvement project was conducted at a Family Medicine practice in Northern New Jersey, and examined current management of common outpatient infections. Study participants received current adult treatment guidelines for upper respiratory infections (URIs), urinary tract infections (UTIs) and superficial skin infections (SSIs). In addition, participants completed an outpatient antibiotic continuing education module, received best practice advisory reminders, and had antibiotic stewardship flyers placed in their offices. Prescriptive patterns were measured using descriptive analysis and McNemar’s test. The results indicated the level of antibiotic stewardship in the outpatient setting remained low amongst all categories of providers for all categories of patients, and that an educational intervention that aimed to improve antibiotic stewardship did not significantly improve adherence to national clinical guidelines between 2017 and 2018 in adult outpatients diagnosed with upper respiratory infections, urinary tract infections and superficial skin infections.DNPIncludes bibliographical reference