Education-Based Intervention to Decrease Unnecessary Antibiotic Prescribing for Uncomplicated Acute Bronchitis

Background and Purpose: Antibiotic resistance is a serious health problem in Oregon and across the United States. The increased incidence is partly due to inappropriate outpatient antibiotic use, especially for uncomplicated acute bronchitis. Methods: In an effort to decrease unnecessary antibiotic prescribing, a 30-minute education seminar for providers was implemented. The content focused on antibiotic stewardship and management of bronchitis using a printed decision support (PDS) guideline algorithm, Wait and See Prescription (WASP) method, and motivational interviewing (MI). The intervention was monitored through eight weeks of data collection, using ICD-10 codes from the electronic health record and a paper-based survey. Conclusions: In the first month, there were no antibiotics prescribed for acute bronchitis, while one was prescribed in the second month. The WASP method was used the most by providers, but the PDS algorithm was perceived to be more helpful. MI was used the least and perceived to be the least helpful. Following the education seminar, 77% of providers felt like they prescribed fewer antibiotics for acute bronchitis. Implications for Practice: When compared to baseline data, there were no significant differences in antibiotic prescribing, suggesting that providers were prescribing antibiotics judiciously at baseline. Variations in provider coding may have impacted the results. Recommendations for the future include extending the data collection period and obtaining information about narrow and broad-spectrum antibiotic use to identify trends and provider education needs