Reducing Outpatient Antibiotic Resistance: A Quasi-Experimental Study

Approved May 2017 by the faculty of UMKC in partial fulfillment of the requirements for the degree of Doctor of Nursing PracticeApproximately 50% of antibiotics prescribed are not necessary, nevertheless in the United States among the many outpatient prescriptions, few are more widely prescribed than antibiotics. The inappropriate use of antibiotics to treat non-bacterial infections has been largely responsible for the emergence of antibiotic resistance. The purpose of this DNP project was to evaluate the effect of an antibiotic stewardship program on urgent care providers’ antibiotic prescribing for acute respiratory infections and to analyze providers’ awareness and beliefs regarding antibiotic use and resistance. A quasi-experimental study was conducted among a convenience sample of eight urgent care providers who received a one hour theory-based intervention program on antibiotic prescribing. Outcomes measured included provider antibiotic prescribing rates pre- and post-intervention, differences in antibiotic prescribing among the providers, and provider attitude and knowledge regarding antibiotic prescribing and resistance. The antibiotic prescribing rate decreased from 30% to 20% post-intervention, p =. 078. The odds ratio of nurse practitioners preferring not to prescribe antibiotics pre-intervention was 3.273 (p = .001) and post-intervention 4.155 (p = < .0005) times more than physicians. Within their setting, 84.43% believed antibiotics are overused, and 92.25% believed antibiotic resistance is a problem. Implementation of an outpatient antibiotic stewardship program is necessary to decrease inappropriate antibiotic prescribing, slow progression of antibiotic resistance, and decrease healthcare costs associated with this world-wide public health problem