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Updated: Jun 3, 2025

Multiplex Therapeutic Drug Monitoring by Isotope-dilution HPLC-MS/MS of Antibiotics in Critical Illnesses

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Published on: August 30, 2018

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

Daniel E Park¹, Annie L S Roberts¹, Rana F Hamdy^2,3

¹Department of Environmental and Occupational Health, George Washington University, Washington, DC, USA.

Infection Control and Hospital Epidemiology

|January 8, 2025

Summary

An antibiotic stewardship intervention reduced inappropriate antibiotic prescribing for bronchitis and viral upper respiratory tract infections in urgent care centers. Active clinician engagement was key to the intervention's success in reducing unnecessary prescriptions.

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Published on: April 18, 2019

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.