Reducing Outpatient Antibiotic Prescribing for Acute Respiratory Infections: A Quasi-Experimental Study.

Problem: Approximately 50% of antibiotics prescribed are not necessary; nevertheless, in the United States among the many outpatient prescriptions, there are few more widely prescribed than antibiotics. The overuse of antibiotics to treat viral infections has been largely responsible for the emergence of antibiotic resistance.

Methods: A quasi-experimental study was conducted among a sample of eight urgent care providers who received the 1-hour Reducing Outpatient Antibiotic Resistance (ROAR) educational intervention on antibiotic overuse and appropriate prescribing. Outcomes measured included provider antibiotic prescribing rates for viral illnesses before and after intervention, prescribing practices among the providers, and provider awareness and beliefs regarding antibiotic prescribing and resistance.

Results: The antibiotic prescribing rate decreased from 30% to 20% after intervention, = .078. Pre-intervention patients had a 3.3 times ( = .001) and post-intervention patients had a 4.2 times ( ≤ .0005) greater likelihood of being prescribed an antibiotic if they were seen by a physician than if they were seen by a nurse practitioner. Within their setting, 87% believed antibiotics are overused, and 99% believed antibiotic resistance is a problem.

Discussion: Additional research utilizing the ROAR intervention is necessary to evaluate its effect on antibiotic prescribing in the urgent care setting.