Implementing an antibiotic stewardship program to decrease antibiotic overuse in a primary care clinic

Abstract

Background: Antibiotic overuse is one of the largest threats to global health. Nearly 50% of antibiotics prescribed in outpatient settings are unnecessary. The overuse of antibiotics is associated with antibiotic resistance, unnecessary adverse drug effects, and increased healthcare costs. Purpose: This quality improvement (QI) project aimed to increase patients’ knowledge and improve their attitude toward appropriate antibiotic use in acute respiratory tract infections (ARTIs) and decrease antibiotic over-prescription by providers through the implementation of an antibiotic stewardship program in a North Texas primary care clinic. Methods: This is a before and-after design QI project that implemented Centers for Disease Control and Prevention’s (CDC) antibiotic stewardship educational intervention. A convenience sample (N=20) was recruited from all interested English-speaking patients who were 18 years or above. Patients’ knowledge and attitude towards antibiotic use was assessed before and after an educational intervention. The second part of the project entailed provider education using a training activity from Stanford University (N=2). Pre- and post-training retrospective chart review was done to determine changes in antibiotic prescription rate. Results: There was a significant increase in patients’ knowledge and their attitude towards appropriate antibiotic use in ARTIs (p < .001) after the educational intervention. Secondly, there was a 15% reduction in antibiotic prescription rate in 2021 compared to the same months in 2020. Conclusion: Provider and patient educational interventions are effective strategies in promoting antibiotic stewardship in outpatient settings and improving inappropriate antibiotic use in ARTIs. Further research is needed to explore innovative educational strategies incorporating inexpensive technology.