How can clinicians prescribe fewer unnecessary antibiotics?
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Click here to read the Cover Story, "‘Shorter is better’ mantra begins to change antibiotic prescribing."
Shorter durations of antibiotic therapy are now recommended for many infections. Although practice has begun to change, the “shorter is better” mantra has not reached all prescribers.
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We asked Kati Shihadeh, PharmD, BCIDP, a clinical pharmacy specialist in infectious diseases at Denver Health Medical Center, for some resources that might help clinicians prescribe fewer antibiotics.
Antibiotic overuse is common, especially in urgent care centers. Despite institutional guidance that recommends 5 days or fewer of antibiotic therapy for many infections, a prior review found prescribed durations were often longer.
This led researchers at Denver Health to study the impact of a multifaceted intervention they called the “Take 5” campaign on guideline-concordant durations of therapy in two urgent care centers.
The intervention included the following components:
- sharing baseline duration of therapy data with site directors and staff;
- providing in-person education on recommended durations of therapy;
- engaging peer champions;
- posting “Take 5” educational flyers to promote 5 days of therapy for common infections; and
- providing an institutional smart phone app with treatment recommendations for common infections.
The intervention resulted in a significant increase in the proportion of antibiotic prescriptions for 5 days or fewer. It could also be effective in other health care settings, including EDs and clinics.
Another component of this intervention that was planned but paused because of the COVID-19 pandemic was providing peer comparison data to prescribers, which also has been shown to improve antibiotic prescribing.
Training prescribers to communicate with patients about their concerns is another strategy that has been shown to reduce inappropriate prescribing in acute respiratory infections.
- References:
- Little P, et al. Ann Fam Med. 2019;doi:10.1370/afm.2356.
- Little P, et al. Lancet. 2013;doi:10.1-16/S0140-6736(13)60994-0.
- Meeker D, et al. JAMA. 2016;doi:10.1001/jama.2016.0275.
- Shihadeh KC, et al. Open Forum Infect Dis. 2021;doi:10.1093/ofid/ofab466.160.
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