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October 2, 2022
Christopher R. Teeple

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Numerous safety and quality improvement initiatives exist to improve population health. One quality improvement initiative that is becoming more well-known and utilized is antibiotic stewardship programs. The agency for healthcare research and quality improvement antibiotic stewardship programs are designed to improve antibiotic use in long-term care, acute care, and ambulatory care settings (Agency for Healthcare Research and Quality [AHRQ], 2019). The centers for disease control and prevention (CDC) provides a set of guidelines for improved antibiotic use with the primary goal of improving patient safety and outcomes (Centers for Disease Control and Prevention [CDC], 2021a). The Be Antibiotics Aware campaign was implemented to combat antibiotic resistance and improve prescribing, with 28 percent of antibiotic courses prescribed annually proven unnecessary (CDC, 2021b). With antibiotic stewardship implementation research provided/proven (T3 phase), it is important for healthcare leaders and professionals to continue to research and develop additional new policies/research while continuing to implement antibiotic stewardship programs. Clinical decision support notifications are one way to promote antibiotic stewardship programs with the utilization of explicit justification in the electronic record. One of the most common occurrences I have witnessed and coordinated with the medical director in long-term care settings is the unnecessary prescribing of antibiotics following emergency room (ER) visits. Often in these situations, there is a stabilize/treat/release protocol, and these patients are returned to the long-term care setting after a few hours (often with a diagnosis of urinary tract infection based on a dipstick result only). We must do better for our patients and not unnecessarily prescribe/provide unnecessary/possibly harmful treatments.

References

Agency for Healthcare Research and Quality. (2019). Antibiotic stewardship tool kits. https://www.ahrq.gov/antibiotic-use/index.html

Centers for Disease Control and Prevention. (2021a). Core elements of antibiotic stewardship. https://www.cdc.gov/antibiotic-use/core-elements/index.html

Centers for Disease Control and Prevention. (2021b). Antibiotic prescribing and use. https://www.cdc.gov/antibiotic-use/index.html

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