Antibiotic Prescribing Variability in a Large Urgent Care Network: A New Target for Outpatient Stewardship

Details

• Alternative Title:
  Clin Infect Dis
• Personal Author:
  Stenehjem, Edward ; Wallin, Anthony ; Fleming-Dutra, Katherine E ; Buckel, Whitney R ; Stanfield, Valoree ; Brunisholz, Kimberly D ; Sorensen, Jeff ; Samore, Matthew H ; Srivastava, Raj ; Hicks, Lauri A ; Hersh, Adam L.
• Description:
  Improving antibiotic prescribing in outpatient settings is a public health priority. In the United States, urgent care (UC) encounters are increasing and have high rates of inappropriate antibiotic prescribing. Our objective was to characterize antibiotic prescribing practices during UC encounters, with a focus on respiratory tract conditions. This was a retrospective cohort study of UC encounters in the Intermountain Healthcare network. Among 1.16 million UC encounters, antibiotics were prescribed during 34% of UC encounters and respiratory conditions accounted for 61% of all antibiotics prescribed. Of respiratory encounters, 50% resulted in antibiotic prescriptions, yet the variability at the level of the provider ranged from 3% to 94%. Similar variability between providers was observed for respiratory conditions where antibiotics were not indicated and in first-line antibiotic selection for sinusitis, otitis media, and pharyngitis. These findings support the importance of developing antibiotic stewardship interventions specifically targeting UC settings.
• Subjects:
  Ambulatory Care Anti-Bacterial Agents Humans Inappropriate Prescribing Outpatients Practice Patterns, Physicians' Respiratory Tract Infections Retrospective Studies United States
• Keywords:
  Antibiotic Stewardship Pediatric Urgent Care Telemedicine Urgent Care
• Source:
  Clin Infect Dis. 70(8):1781-1787
• Pubmed ID:
  31641768
• Pubmed Central ID:
  PMC7768670
• Document Type:
  Journal Article
• Funding:
  CC999999/ImCDC/Intramural CDC HHSUnited States/ ; HHSD200201691799I/ImCDC/Intramural CDC HHSUnited States/ ; UL1 TR002538/TR/NCATS NIH HHSUnited States/
• Volume:
  70
• Issue:
  8
• Collection(s):
  CDC Public Access
• Main Document Checksum:
  urn:sha-512:d05e642cf223ab2c2013d74e5df674747502285efae98297fdd43ec633b776707b739d86379b1eebe15b1dc9283dde256d9ab61bc5cc247c32210247ca73e105
• Download URL:
  https://stacks.cdc.gov/view/cdc/119551/cdc_119551_DS1.pdf
• File Type:
  [PDF - 268.51 KB ]