Improving Antibiotic Stewardship in the Outpatient Setting, A Quality Improvement Project
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Background: At least two million people acquire serious antibiotic-resistant infections each year and at least 23,000 people die as a result of those infections. In general, antibiotic-resistant infections can cost as much as $20 billion in direct health care costs with an additional cost of as much as $35 billion to society for lost productivity (CDC, 2013). Objective: The purpose of this quality improvement project was to assist an outpatient clinic evaluate its current antibiotic prescribing habits through audit and feedback, as well as address gaps in clinical practice through clinician education and policy development. Methods: Data was collected from January 2, 2017, through April 29, 2017 for 12 participating providers. The facility’s data analyst ran a report including patient encounters for those 12 years and older who were diagnosed with any of the following: bronchitis, common cold, sinusitis, pharyngitis, tonsillitis, upper respiratory infection (URI), cough, and otitis media. The number of antibiotics prescribed for the selected diagnoses were then recorded for each individual provider, as well as collectively as a group. Results: The number of charts reviewed was 1,009 with 602 charts being prescribed an antibiotic. Bronchitis, sinusitis, and URI were the top three diagnoses associated with the most antibiotic prescriptions with 163, 174, and 134. Conclusions: Providers are not consistently following clinical practice guidelines when developing treatment plans for common viral infection; however, the results showed where clear gaps in clinical practice lie and where clinician education could be provided.