Adherence to CDC Guidelines on Adult Sinusitis and Pharyngitis Before and After Provider Training

Description: The purpose of this project was to determine whether provider training on the Centers for Disease Control and Prevention (CDC) adult treatment recommendations on adult sinusitis and pharyngitis encouraged more judicious antibiotic use in a college health setting. Problem Statement: Antibiotic resistance (ABR) rates are increasing, with a leading cause being inappropriate prescribing of antibiotics by providers. The CDC's Get Smart Know When Antibiotics Work campaign promotes appropriate and effective use of antibiotics in order to stem the ABR epidemic. It was unknown how well providers at a local college health center adhere to the CDC adult treatment recommendations on acute sinusitis and acute pharyngitis, and whether provider training on these recommendations would encourage more judicious antibiotic prescribing in this setting. Objectives: The objectives of this project were: 1. Measure baseline adherence to CDC guidelines for adult sinusitis and pharyngitis. 2. Provide academic detailing to providers on CDC guidelines stated above. 3. Measure follow-up adherence score to CDC guidelines stated above. 4. Provide feedback and results to providers to determine if there is a need for continued practice changes. 5. Disseminate project to peers through professional poster presentation. Literature Review: The CDC reported over two million ABR infections and 23,000 deaths related to ABR infections alone in 2013. The consequences of inappropriate antibiotic prescribing include increased ABR, decreased utility of existing antibiotics, increased medical costs, and poorer patient outcomes. Thus, it is critical that healthcare providers and organizations encourage responsible antibiotic prescribing. Responsible prescribing has been shown to improve patient outcomes and decrease the rate of antibiotic resistance. Successful antibiotic stewardship is the end goal of the CDC's Get Smart: Know When Antibiotics Work campaign. Implementation & Evaluation: A baseline chart review was performed to assess adherence to CDC treatment recommendations. Academic detailing with associated pre/post-tests was then offered to providers to improve their knowledge of adult treatment recommendations for acute sinusitis and pharyngitis. A follow-up chart review was performed 2 months later to determine provider adherence to CDC treatment recommendations. Baseline and follow-up adherence scores was determined by the number of appropriate antibiotic prescriptions that followed the CDC recommendations. The results were compared to determine if adherence improved. The results were shared and discussed with providers. Finally, an application was submitted to the 2016 CME Snowbird conference for dissemination of this project. Results: Provider knowledge of adult treatment recommendations increased significantly (P-value=0.001) based on the pre- and post-test completed at the time of the provider training. Adherence to both the CDC adult pharyngitis and sinusitis guidelines increased when comparing the pre-training chart review with the post-training chart review.