Evaluating an urgent care antibiotic stewardship intervention: a multi-network collaborative effort.

Area of Science:

• Infectious Diseases
• Public Health
• Healthcare Quality Improvement

Background:

• Urgent care centers (UCCs) exhibit high rates of antibiotic prescribing for acute respiratory tract infections.
• Existing studies on UCC antibiotic stewardship are often limited to single networks, necessitating broader, generalizable efforts.

Purpose of the Study:

• To assess the effectiveness of an antibiotic stewardship intervention in reducing inappropriate antibiotic prescribing for bronchitis and viral upper respiratory tract infections (URTIs) within UCCs.
• To evaluate the impact of clinician engagement on the intervention's success.

Main Methods:

• A quality improvement study was conducted across 49 UCCs in 27 networks.
• The intervention involved clinician commitment and selection from various options over three plan-do-study-act cycles.
• A regression model using generalized estimating equations compared prescribing rates pre- and post-intervention.

Main Results:

• A significant decrease in inappropriate antibiotic prescribing for bronchitis (48% relative decrease) and viral URTIs (33% decrease) was observed among actively engaged clinicians.
• The intervention showed no significant impact on prescribing rates for clinicians who were not actively engaged.
• Data analyzed from 15,385 encounters.

Conclusions:

• The antibiotic stewardship intervention effectively reduced inappropriate prescribing for common respiratory infections in UCCs.
• Active engagement of clinicians is crucial for the success of such stewardship interventions.
• Implementing targeted stewardship programs in UCCs holds potential for optimizing antibiotic use.