It’s about the patients: Practical antibiotic stewardship in outpatient settings in the United States
Antibiotic-resistant pathogens cause over 35,000 preventable deaths in the United States every year, and multiple strategies could decrease morbidity and mortality. As antibiotic stewardship requirements are being deployed for the outpatient setting, community providers are facing systematic challen...
| Main Authors: | , , , , , , , , |
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| Format: | Article |
| Language: | English |
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Frontiers Media S.A.
2022-07-01
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| Series: | Frontiers in Medicine |
| Subjects: | |
| Online Access: | https://www.frontiersin.org/articles/10.3389/fmed.2022.901980/full |
| _version_ | 1818161814419013632 |
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| author | Alpesh N. Amin E. Patchen Dellinger Glenn Harnett Bryan D. Kraft Kerry L. LaPlante Frank LoVecchio James A. McKinnell Glenn Tillotson Salisia Valentine |
| author_facet | Alpesh N. Amin E. Patchen Dellinger Glenn Harnett Bryan D. Kraft Kerry L. LaPlante Frank LoVecchio James A. McKinnell Glenn Tillotson Salisia Valentine |
| author_sort | Alpesh N. Amin |
| collection | DOAJ |
| description | Antibiotic-resistant pathogens cause over 35,000 preventable deaths in the United States every year, and multiple strategies could decrease morbidity and mortality. As antibiotic stewardship requirements are being deployed for the outpatient setting, community providers are facing systematic challenges in implementing stewardship programs. Given that the vast majority of antibiotics are prescribed in the outpatient setting, there are endless opportunities to make a smart and informed choice when prescribing and to move the needle on antibiotic stewardship. Antibiotic stewardship in the community, or “smart prescribing” as we suggest, should factor in antibiotic efficacy, safety, local resistance rates, and overall cost, in addition to patient-specific factors and disease presentation, to arrive at an appropriate therapy. Here, we discuss some of the challenges, such as patient/parent pressure to prescribe, lack of data or resources for implementation, and a disconnect between guidelines and real-world practice, among others. We have assembled an easy-to-use best practice guide for providers in the outpatient setting who lack the time or resources to develop a plan or consult lengthy guidelines. We provide specific suggestions for antibiotic prescribing that align real-world clinical practice with best practices for antibiotic stewardship for two of the most common bacterial infections seen in the outpatient setting: community-acquired pneumonia and skin and soft-tissue infection. In addition, we discuss many ways that community providers, payors, and regulatory bodies can make antibiotic stewardship easier to implement and more streamlined in the outpatient setting. |
| first_indexed | 2024-12-11T16:23:45Z |
| format | Article |
| id | doaj.art-0add439580eb42869f79e8060ea1d38a |
| institution | Directory Open Access Journal |
| issn | 2296-858X |
| language | English |
| last_indexed | 2024-12-11T16:23:45Z |
| publishDate | 2022-07-01 |
| publisher | Frontiers Media S.A. |
| record_format | Article |
| series | Frontiers in Medicine |
| spelling | doaj.art-0add439580eb42869f79e8060ea1d38a2022-12-22T00:58:47ZengFrontiers Media S.A.Frontiers in Medicine2296-858X2022-07-01910.3389/fmed.2022.901980901980It’s about the patients: Practical antibiotic stewardship in outpatient settings in the United StatesAlpesh N. Amin0E. Patchen Dellinger1Glenn Harnett2Bryan D. Kraft3Kerry L. LaPlante4Frank LoVecchio5James A. McKinnell6Glenn Tillotson7Salisia Valentine8Department of Medicine, University of California, Irvine, Irvine, CA, United StatesDepartment of Surgery, University of Washington, Seattle, WA, United StatesNo Resistance Consulting, Birmingham, AL, United StatesDivision of Pulmonary and Critical Care Medicine, Department of Medicine, Washington University School of Medicine, St. Louis, MO, United StatesCollege of Pharmacy, University of Rhode Island, Kingston, RI, United StatesDepartment of Emergency Medicine, Valleywise Health, Arizona State University, Phoenix, AZ, United StatesInfectious Disease Clinical Outcomes Research Unit, Division of Infectious Disease, Lundquist Research Institute at Harbor-UCLA, Torrance, CA, United StatesGST Micro LLC, North, VA, United StatesAmerican Family Care, Birmingham, AL, United StatesAntibiotic-resistant pathogens cause over 35,000 preventable deaths in the United States every year, and multiple strategies could decrease morbidity and mortality. As antibiotic stewardship requirements are being deployed for the outpatient setting, community providers are facing systematic challenges in implementing stewardship programs. Given that the vast majority of antibiotics are prescribed in the outpatient setting, there are endless opportunities to make a smart and informed choice when prescribing and to move the needle on antibiotic stewardship. Antibiotic stewardship in the community, or “smart prescribing” as we suggest, should factor in antibiotic efficacy, safety, local resistance rates, and overall cost, in addition to patient-specific factors and disease presentation, to arrive at an appropriate therapy. Here, we discuss some of the challenges, such as patient/parent pressure to prescribe, lack of data or resources for implementation, and a disconnect between guidelines and real-world practice, among others. We have assembled an easy-to-use best practice guide for providers in the outpatient setting who lack the time or resources to develop a plan or consult lengthy guidelines. We provide specific suggestions for antibiotic prescribing that align real-world clinical practice with best practices for antibiotic stewardship for two of the most common bacterial infections seen in the outpatient setting: community-acquired pneumonia and skin and soft-tissue infection. In addition, we discuss many ways that community providers, payors, and regulatory bodies can make antibiotic stewardship easier to implement and more streamlined in the outpatient setting.https://www.frontiersin.org/articles/10.3389/fmed.2022.901980/fullantibiotic stewardshipantimicrobial stewardshiptherapeutic antibacterial agentsmicrobial drug resistancepneumoniainfectious skin diseases |
| spellingShingle | Alpesh N. Amin E. Patchen Dellinger Glenn Harnett Bryan D. Kraft Kerry L. LaPlante Frank LoVecchio James A. McKinnell Glenn Tillotson Salisia Valentine It’s about the patients: Practical antibiotic stewardship in outpatient settings in the United States Frontiers in Medicine antibiotic stewardship antimicrobial stewardship therapeutic antibacterial agents microbial drug resistance pneumonia infectious skin diseases |
| title | It’s about the patients: Practical antibiotic stewardship in outpatient settings in the United States |
| title_full | It’s about the patients: Practical antibiotic stewardship in outpatient settings in the United States |
| title_fullStr | It’s about the patients: Practical antibiotic stewardship in outpatient settings in the United States |
| title_full_unstemmed | It’s about the patients: Practical antibiotic stewardship in outpatient settings in the United States |
| title_short | It’s about the patients: Practical antibiotic stewardship in outpatient settings in the United States |
| title_sort | it s about the patients practical antibiotic stewardship in outpatient settings in the united states |
| topic | antibiotic stewardship antimicrobial stewardship therapeutic antibacterial agents microbial drug resistance pneumonia infectious skin diseases |
| url | https://www.frontiersin.org/articles/10.3389/fmed.2022.901980/full |
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