Initiative for Appropriate Antibiotic Prescribing Practices in the Emergency Setting

The overuse and misuse of antibiotics has been a health concern for years and effects people all over the world. While improvements have been made in antimicrobial stewardship, progress continues to be slow in preventing inappropriate prescriptions. There remains a need to assess and improve antimicrobial use in outpatient services such as the emergency department (ED). Two main categories of disease processes that are frequently treated with antibiotics include upper respiratory infections (URI) and urinary tract infections (UTI). The lack of education is currently the primary reason for the delay in following current best practice guidelines. The development of a quality improvement (QI) project to improve antibacterial prescribing practices that align with current guidelines and best practice recommendations was the purpose of this project. This project examines those guidelines and analyzes the provider practices before and after an educational intervention which concluded that provider practice may be influenced through educational opportunities. After an educational intervention findings for this project include significant decrease in antibiotic usage for bronchitis which was reduced from 55% to 10%. Bactrim was also seen to be used less frequently but overall appropriateness of treatment for UTI declined after the intervention. UTIs continued to be treated with antibiotic courses that were too long according to national guidelines. These results show possible benefit from educational interventions and this topic warrants further studies to continue to improve antimicrobial stewardship.