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ANTIBIOTIC STEWARDSHIP FOR ACUTE BRONCHITIS: A QUALITY IMPROVEMENT (QI) STUDY IN UNIVERSITY HEALTHCARE
  1. Pasquale Frisina,
  2. Jonathan Pletcher,
  3. Esther Munene,
  4. John Kolligian
  1. University Health Services, Princeton University, United States

Abstract

Background Acute bronchitis is a leading cause of ambulatory care visits within the United States. Despite the well-established prevalence of viral etiologies among young adults, over-prescribing of antibiotics persists. This prescribing pattern is concerning because of microbial antibiotic resistance and adverse drug reactions. Therefore, we initiated a QI-study to drive antibiotic stewardship for acute uncomplicated bronchitis (AUB) within a university-based healthcare setting.

Objectives Apply common prescribing guidelines in an effort to reduce our antibiotic prescription rate for AUB to a level of 10% or less.

Methods The following QI-interventions were implemented, consistent with the IHI-Model for Improvement: (1) clinicians provided education to patients on viral respiratory infections, including a care plan and information on the potential harm from antibiotics; (2) clinicians employed the term “chest cold” for AUB in the absence of criteria indicating bacterial infection; and (3) antibiotic stewardship for AUB was included in peer chart reviews, including follow-up education to providers as needed.

Results The QI-interventions significantly reduced our antibiotic prescription rate from a baseline of 80% to a level of 5% (5 out of 91 charts) within one cycle of Plan-Do-Study-Act, Chi-square (1)=4.07, p<.05.

Conclusions Antibiotic stewardship related to AUB improved to 95% compliance with clinical guidelines through staff and patient education, and regular peer chart review. This effort is of particular importance in college health as this represents a unique opportunity to educate young adults, often novice consumers of healthcare, on the appropriate use of antibiotics.

  • Accreditation
  • Anaesthesia
  • Attitudes

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