Antibiotic Stewardship Improvement Initiative at a Veterans Health Administration Ambulatory Care Center.

Abstract

The negative impact of unnecessary antibiotic prescribing is well known and includes risks of antibiotic adverse effects, overgrowth of pathogenic organisms, unnecessary costs, and selection of antibiotic-resistant organisms in the populace at large. Acute viral respiratory infections are among the leading causes of inappropriate antibiotic usage. This study examined the effect on inappropriate antibiotic prescribing rates of educating clinicians regarding antibiotic stewardship and making a prepackaged kit (containing symptom relief and patient education) for clinicians to distribute to patients with viral upper respiratory tract infections vs writing a prescription for antibiotics. Between December 1, 2018, and March 31, 2019, 357 viral illness support packs were distributed. Antibiotic prescriptions for the diagnostic codes pertaining to viral upper respiratory tract infections were tracked and compared to a similar period from December 1, 2017, to March 31, 2018. A 9% reduction in antibiotic prescriptions was observed (P = .02). The results of this project demonstrate that the combination of patient education and the ready availability of a nonantibiotic symptomatic treatment option can significantly decrease the unnecessary prescribing of antibiotics for viral illnesses.