Antibiotic Stewardship Program Development in a Rural Urgent Care Clinic

Problem: The misuse and overuse of antibiotics are critical factors leading to antimicrobial resistance (AMR) and infections becoming harder to treat. Most antibiotics are prescribed in outpatient settings for upper respiratory infections (URIs), yet these infections are commonly caused by viruses that antibiotics cannot treat. An urgent care clinic (UCC) in Upstate New York was audited for antibiotic prescribing for URIs. Fifty-five percent of patients who presented with a URI were prescribed an antibiotic, even when most did not meet treatment guidelines criteria.Aims: This quality improvement (QI) project aimed to develop and implement an outpatient antibiotic stewardship program in a UCC in rural Upstate New York. The project’s goal was to decrease inappropriate antibiotic prescribing for treating URIs through clinician and patient education, quarterly updates from the pharmacy regarding antibiotic treatment guidelines, and peer-to-peer evaluation.Method: This QI project used a model of improvement design to develop an outpatient antibiotic stewardship program. The Centers for Disease Control and Prevention’s (CDC) four core elements of outpatient antibiotic stewardship were the framework for this evidence-based program. The UCC clinicians were educated on antibiotic treatment guidelines and advised on practice policy. To measure the effectiveness of the intervention, antibiotic prescription audits were conducted at three months, and a final evaluation was completed at the end of six months.Results: A total of 240 patient charts diagnosed with a URI were reviewed following the implementation of the antibiotic stewardship program. Only 38 patients were prescribed antibiotics. Reductions in antibiotic prescriptions for URI went from 55% to 16%. All patients treated with antibiotics met documented symptoms and exam criteria for antibiotic treatment.Conclusion: Viral respiratory screening with point-of-care testing played a significant role in the success of this QI project. A positive viral respiratory screen proved helpful ruling in viral infections. Clinicians were more confident in their diagnosis and symptomatic management treatment plan. The patients, in turn, were more open to receiving a treatment plan that did not include antibiotics.

Grantor dc:publisher

University of Kansas

Year dc:date.issued

2022

Author dc:creator

• Ndungu, Joyce

Advisor dc:contributor.advisor

• Paramesh, Colleen

• Public health education
• antibiotic stewardship program
• Antimicrobial resistance
• upper respiratory infections
• urgent care clinic

Statement dc:rights

• Copyright held by the author.

Language dc:language.iso

en

Dc Identifier Other

http://dissertations.umi.com/ku:18702

OAI identifier oai:identifier

oai:kuscholarworks.ku.edu:1808/36651