Introducing antimicrobial stewardship to the outpatient clinics of a suburban academic health system
Abstract Objective: To establish an antimicrobial stewardship program in the outpatient setting. Design: Prescribers of antimicrobials were asked to complete a survey regarding antimicrobial stewardship. We also monitored their compliance with appropriate prescribing practices, which were shared...
| Main Authors: | , , , , , , |
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| Format: | Article |
| Language: | English |
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Cambridge University Press
2022-01-01
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| Series: | Antimicrobial Stewardship & Healthcare Epidemiology |
| Online Access: | https://www.cambridge.org/core/product/identifier/S2732494X2100228X/type/journal_article |
| _version_ | 1811157200686546944 |
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| author | Travis B. Nielsen Maressa Santarossa Beatrice Probst Laurie Labuszewski Jenna Lopez Mary Barsanti-Sekhar Fritzie Albarillo |
| author_facet | Travis B. Nielsen Maressa Santarossa Beatrice Probst Laurie Labuszewski Jenna Lopez Mary Barsanti-Sekhar Fritzie Albarillo |
| author_sort | Travis B. Nielsen |
| collection | DOAJ |
| description |
Abstract
Objective:
To establish an antimicrobial stewardship program in the outpatient setting.
Design:
Prescribers of antimicrobials were asked to complete a survey regarding antimicrobial stewardship. We also monitored their compliance with appropriate prescribing practices, which were shared in monthly quality improvement reports.
Setting:
The study was performed at Loyola University Health System, an academic teaching healthcare system in a metropolitan suburban environment.
Participants:
Prescribers of antimicrobials across 19 primary care and 3 immediate- and urgent-care clinics.
Methods:
The voluntary survey was developed using SurveyMonkeyand was distributed via e-mail. Data were collected anonymously. Rates of compliance with appropriate prescribing practices were abstracted from electronic health records and assessed by 3 metrics: (1) avoidance of antibiotics in adult acute bronchitis and appropriate antibiotic treatment in (2) patients tested for pharyngitis and (3) children with upper respiratory tract infections.
Results:
Prescribers were highly knowledgeable about what constitutes appropriate prescribing; verified compliance rates were highly concordant with self-reported rates. Nearly all prescribers were concerned about resistance, but fewer than half believed antibiotics were overprescribed in their office. Among respondents, 74% reported intense pressure from patients to prescribe antimicrobials inappropriately. Immediate- and urgent-care prescribers had higher rates of compliance than primary-care prescribers, and the latter group responded well to monthly reports and online educational resources.
Conclusions:
Intense pressure from patients to prescribe antimicrobials when they are not indicated leads to overprescribing, an effect compounded by the importance of patient satisfaction scores. Compliance reporting improved the number of appropriate antibiotics prescribed in the primary care setting.
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| first_indexed | 2024-04-10T05:03:09Z |
| format | Article |
| id | doaj.art-f4615b9c2e1c4cdba2267d74028710be |
| institution | Directory Open Access Journal |
| issn | 2732-494X |
| language | English |
| last_indexed | 2024-04-10T05:03:09Z |
| publishDate | 2022-01-01 |
| publisher | Cambridge University Press |
| record_format | Article |
| series | Antimicrobial Stewardship & Healthcare Epidemiology |
| spelling | doaj.art-f4615b9c2e1c4cdba2267d74028710be2023-03-09T12:28:16ZengCambridge University PressAntimicrobial Stewardship & Healthcare Epidemiology2732-494X2022-01-01210.1017/ash.2021.228Introducing antimicrobial stewardship to the outpatient clinics of a suburban academic health systemTravis B. Nielsen0https://orcid.org/0000-0003-3366-7912Maressa Santarossa1https://orcid.org/0000-0002-2128-5813Beatrice Probst2Laurie Labuszewski3Jenna Lopez4Mary Barsanti-Sekhar5Fritzie Albarillo6https://orcid.org/0000-0002-3441-301XLoyola University Chicago Stritch School of Medicine, Maywood, Illinois University of Southern California Keck School of Medicine, Los Angeles, CaliforniaLoyola University Health System, Maywood, IllinoisLoyola University Chicago Stritch School of Medicine, Maywood, Illinois Loyola University Health System, Maywood, IllinoisMercy Hospital & Medical Center, Chicago, IllinoisLoyola University Chicago Stritch School of Medicine, Maywood, Illinois Loyola University Health System, Maywood, IllinoisLoyola University Chicago Stritch School of Medicine, Maywood, Illinois Loyola University Health System, Maywood, IllinoisLoyola University Chicago Stritch School of Medicine, Maywood, Illinois Loyola University Health System, Maywood, Illinois Abstract Objective: To establish an antimicrobial stewardship program in the outpatient setting. Design: Prescribers of antimicrobials were asked to complete a survey regarding antimicrobial stewardship. We also monitored their compliance with appropriate prescribing practices, which were shared in monthly quality improvement reports. Setting: The study was performed at Loyola University Health System, an academic teaching healthcare system in a metropolitan suburban environment. Participants: Prescribers of antimicrobials across 19 primary care and 3 immediate- and urgent-care clinics. Methods: The voluntary survey was developed using SurveyMonkeyand was distributed via e-mail. Data were collected anonymously. Rates of compliance with appropriate prescribing practices were abstracted from electronic health records and assessed by 3 metrics: (1) avoidance of antibiotics in adult acute bronchitis and appropriate antibiotic treatment in (2) patients tested for pharyngitis and (3) children with upper respiratory tract infections. Results: Prescribers were highly knowledgeable about what constitutes appropriate prescribing; verified compliance rates were highly concordant with self-reported rates. Nearly all prescribers were concerned about resistance, but fewer than half believed antibiotics were overprescribed in their office. Among respondents, 74% reported intense pressure from patients to prescribe antimicrobials inappropriately. Immediate- and urgent-care prescribers had higher rates of compliance than primary-care prescribers, and the latter group responded well to monthly reports and online educational resources. Conclusions: Intense pressure from patients to prescribe antimicrobials when they are not indicated leads to overprescribing, an effect compounded by the importance of patient satisfaction scores. Compliance reporting improved the number of appropriate antibiotics prescribed in the primary care setting. https://www.cambridge.org/core/product/identifier/S2732494X2100228X/type/journal_article |
| spellingShingle | Travis B. Nielsen Maressa Santarossa Beatrice Probst Laurie Labuszewski Jenna Lopez Mary Barsanti-Sekhar Fritzie Albarillo Introducing antimicrobial stewardship to the outpatient clinics of a suburban academic health system Antimicrobial Stewardship & Healthcare Epidemiology |
| title | Introducing antimicrobial stewardship to the outpatient clinics of a suburban academic health system |
| title_full | Introducing antimicrobial stewardship to the outpatient clinics of a suburban academic health system |
| title_fullStr | Introducing antimicrobial stewardship to the outpatient clinics of a suburban academic health system |
| title_full_unstemmed | Introducing antimicrobial stewardship to the outpatient clinics of a suburban academic health system |
| title_short | Introducing antimicrobial stewardship to the outpatient clinics of a suburban academic health system |
| title_sort | introducing antimicrobial stewardship to the outpatient clinics of a suburban academic health system |
| url | https://www.cambridge.org/core/product/identifier/S2732494X2100228X/type/journal_article |
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