Reducing Community-Acquired CDIFF Admissions: Outpatient Antimicrobial Stewardship

According to the CDC, approximately 80%-90% of antibiotic use occurs among outpatients and at least 30% of these prescriptions are unnecessary.

In 2024, multidisciplinary team at our institution developed a program to monitor outpatient antibiotic use for high priority respiratory conditions. Best practice guidelines from the Agency for Healthcare Research and Quality Outpatient Antibiotic Stewardship Toolkit were used, and feedback was provided to providers in the program. Data were tracked using an electronic medical record to pull high priority respiratory conditions such as upper respiratory infection, acute bronchitis, sinusitis, otitis media, pharyngitis, and pneumonia by ICD-10.

Antibiotic Prescription rates decreased from 528.32 antibiotics per 1,000 persons in 2023 to 270.91 in 2024 ( p < .05). Overall community-acquired C. difficile admissions decreased from 21 in 2023 to 16 in 2024 ( p > .05). The percentage of C. difficile admissions with outpatient antibiotics within 90 days reduced from 8 (33%) in 2023 to 1 (6%) in 2024 ( p < .05).

Outpatient Antibiotic Stewardship Programs can reduce the number of inappropriate prescriptions potentially leading to a reduced risk for patients developing C. difficile . A cost savings was established to promote key stakeholder buy in and program sustainability.