Improved Antibiotic Prescribing within a Veterans Affairs Primary Care System through a Multifaceted Intervention Centered on Peer Comparison of Overall Antibiotic Prescribing Rates

Reducing inappropriate outpatient antibiotic use is an important national goal. Limited data exist on targeted education and peer comparison of overall antibiotic prescribing rates as an antimicrobial stewardship strategy. Primary care professionals (PCPs) from all seven clinics within our health ca...

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Bibliographic Details
Published in:Antimicrobial agents and chemotherapy 2019-12, Vol.64 (1)
Main Authors: Shively, Nathan R, Buehrle, Deanna J, Wagener, Marilyn M, Clancy, Cornelius J, Decker, Brooke K
Format: Article
Language:English
Subjects:
Anti-Bacterial Agents - therapeutic use
Antimicrobial Stewardship - statistics & numerical data
Antimicrobial Stewardship - trends
Epidemiology and Surveillance
Humans
Inappropriate Prescribing - prevention & control
Inappropriate Prescribing - statistics & numerical data
Inappropriate Prescribing - trends
Peer Group
Pennsylvania
Practice Patterns, Physicians' - statistics & numerical data
Practice Patterns, Physicians' - trends
Primary Health Care
United States
United States Department of Veterans Affairs
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Summary:Reducing inappropriate outpatient antibiotic use is an important national goal. Limited data exist on targeted education and peer comparison of overall antibiotic prescribing rates as an antimicrobial stewardship strategy. Primary care professionals (PCPs) from all seven clinics within our health care system were offered an education session, followed by monthly e-mails with their antibiotic prescribing rate, peer prescribing rates, and a system target. A pre-post analysis was conducted to compare prescribing rates during the intervention period (January to June 2017) to a seasonal baseline (January to June 2016) using a regression model. A random sample of prescriptions was reviewed for adherence to consensus guidelines. Educational sessions were attended by 68.5% (50/73) of PCPs. From the baseline to the intervention period, the mean rate of monthly antibiotic prescriptions declined from 76.9 to 49.5 per 1,000 office visits (35.6% reduction [  
ISSN:0066-4804
1098-6596
DOI:10.1128/AAC.00928-19