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Antibiotic Scorecards Lead to More Appropriate Prescribing

Antibiotic resistance is not solely driven by inappropriate prescribing, but inappropriate antibiotic prescriptions are largely responsible for the accelerated rate of resistance development.

In an abstract planned for presentation at the now-cancelled 23rd Annual Making a Difference in Infectious Diseases (MAD-ID) Conference, investigators from Saint Francis Hospital and Medical Center share results of a study in which antimicrobial stewardship education was conducted with de-identified provider-specific prescribing scorecards.

Previous study at Saint Francis Hospital and Medical Center had identified areas in need of improvement in outpatient prescribing for respiratory infections, urinary tract infections, and skin & soft tissue infections. Pharmacists intervened by providing education via prescribing scorecards and antibiotic algorithms for the previously mentioned indications.

The investigators reviewed outpatient antibiotic prescription data and medical records for patients in adult primary care clinics from July 2017-June 2018. A post-intervention time period, April-September 2019, was assessed as well.

The study team looked at patient demographics, antibiotic prescriptions, patient allergies, and indications. Investigators evaluated appropriate medication choice and therapy duration using documented indications and clinical practice guidelines.

“The primary outcome was the rate of inappropriate antibiotic prescriptions for respiratory infections, SSTIs and UTIs before and after providing education with the de-identified provider-specific prescribing scorecard,” investigators wrote.

Through the program, the rate of inappropriate antibiotic prescriptions in the 3 combined areas for improvement was reduced from 74% to 56% following us of the de-identified prescriber scorecard. Most improvement was driven by reductions in inappropriate prescribing for skin & soft tissue infections (97% pre-intervention, 67% post-intervention) and UTIs (60% pre-intervention, 19% post-intervention).

Inappropriate prescribing rates in respiratory infections were not significant (66% pre-intervention, 61% post- intervention).

The study team highlighted that a mere 1-time educational intervention led to an 18.4% decrease in the rate of inappropriate antibiotic prescriptions for 3 common indications.

The abstract, “Impact of antimicrobial stewardship education using a de-identified, provider-specific prescribing scorecard on outpatient antibiotic prescribing practices,” was published by the organizers of MAD-ID 2020.
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