Antibiotic resistance is a public health priority. Estimates show that around 700,000 people die annually as a consequence of drug-resistant infections. An estimated 30% of antibiotics prescribed in the outpatient setting are unnecessary, compounding this serious community health threat. In 2018, NewYork-Presbyterian Queens established its Outpatient Antibiotic Stewardship Program, which aims to decrease inappropriate antibiotic prescribing, antibiotic resistance and future development of infections caused by multidrug-resistant organisms, adverse drug events and onset of infections.
These goals are achieved with a multipronged intervention comprised of provider education, clinical decision support tools, delayed antibiotic prescribing services, data reporting and analysis and patient education. Hospital and community-based programming are combined, expanding and improving interventions. The program partners with local community organizations and delivers culturally appropriate patient education. Monthly educational seminars are conducted at local libraries, churches and senior centers. The initiative focuses on the diversity of NewYork-Presbyterian Queens’ patient population to address gaps in education, opportunities for behavioral improvement and serious consequences resulting from the misuse of antibiotics.
Average antibiotic prescribing incidence during respiratory season for upper respiratory tract infections across all practices decreased from 49% to 38.4% after the implementation of Outpatient Antibiotic Stewardship Program protocols. There was also improvement in the appropriateness of antibiotic selection. Post-intervention, prescribing of the preferred antibiotic increased from 25% to 30% and the less-preferred antibiotic decreased from 55% to 47%.
For more information, contact George D. Rodriguez, PharmD, manager, Antimicrobial Stewardship Program, at (718) 640-7851 or firstname.lastname@example.org.