How Intermountain cut antibiotic overprescribing

Intermountain Health reduced antibiotic prescribing in urgent care clinics by 15 percent after rolling out new stewardship initiatives, according to a study published May 11 in JAMA Network Open.

Researchers from Intermountain and University of Utah Health, both in Salt Lake City, created an urgent care-specific antimicrobial stewardship program that was rolled out at 38 Intermountain urgent care sites in July 2019. Efforts included physician and patient education, new EHR tools and benchmarking dashboards to track each clinic's progress.  

To assess the program's efficacy, researchers tracked antibiotic prescriptions given to patients presenting with respiratory conditions such as bronchitis or sinusitis — which are historically associated with high rates of inappropriate antibiotic prescriptions — before and after the intervention period.

Before the new program was implemented, 48 percent of clinic visits for respiratory conditions resulted in clinicians writing an antibiotic prescription. This figure fell to 33 percent after the stewardship program was implemented, and improvements were sustained even after the study period ended, researchers said. 

"Antibiotic stewardship can be done — and done well in urgent care settings," lead author Edward Stenehjem, MD, Intermountain's medical director of antimicrobial stewardship, said in a May 11 news release. "That's especially true for urgent care centers that are integrated into healthcare systems. These results show the role we can play in reducing prescribing rates in these critical and unique care settings, which is better for patients and our community overall."

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