TY - JOUR
T1 - It’s about the patients
T2 - Practical antibiotic stewardship in outpatient settings in the United States
AU - Amin, Alpesh N.
AU - Dellinger, E. Patchen
AU - Harnett, Glenn
AU - Kraft, Bryan D.
AU - LaPlante, Kerry L.
AU - LoVecchio, Frank
AU - McKinnell, James A.
AU - Tillotson, Glenn
AU - Valentine, Salisia
N1 - Publisher Copyright:
Copyright © 2022 Amin, Dellinger, Harnett, Kraft, LaPlante, LoVecchio, McKinnell, Tillotson and Valentine.
PY - 2022/7/27
Y1 - 2022/7/27
N2 - Antibiotic-resistant pathogens cause over 35,000 preventable deaths in the United States every year, and multiple strategies could decrease morbidity and mortality. As antibiotic stewardship requirements are being deployed for the outpatient setting, community providers are facing systematic challenges in implementing stewardship programs. Given that the vast majority of antibiotics are prescribed in the outpatient setting, there are endless opportunities to make a smart and informed choice when prescribing and to move the needle on antibiotic stewardship. Antibiotic stewardship in the community, or “smart prescribing” as we suggest, should factor in antibiotic efficacy, safety, local resistance rates, and overall cost, in addition to patient-specific factors and disease presentation, to arrive at an appropriate therapy. Here, we discuss some of the challenges, such as patient/parent pressure to prescribe, lack of data or resources for implementation, and a disconnect between guidelines and real-world practice, among others. We have assembled an easy-to-use best practice guide for providers in the outpatient setting who lack the time or resources to develop a plan or consult lengthy guidelines. We provide specific suggestions for antibiotic prescribing that align real-world clinical practice with best practices for antibiotic stewardship for two of the most common bacterial infections seen in the outpatient setting: community-acquired pneumonia and skin and soft-tissue infection. In addition, we discuss many ways that community providers, payors, and regulatory bodies can make antibiotic stewardship easier to implement and more streamlined in the outpatient setting.
AB - Antibiotic-resistant pathogens cause over 35,000 preventable deaths in the United States every year, and multiple strategies could decrease morbidity and mortality. As antibiotic stewardship requirements are being deployed for the outpatient setting, community providers are facing systematic challenges in implementing stewardship programs. Given that the vast majority of antibiotics are prescribed in the outpatient setting, there are endless opportunities to make a smart and informed choice when prescribing and to move the needle on antibiotic stewardship. Antibiotic stewardship in the community, or “smart prescribing” as we suggest, should factor in antibiotic efficacy, safety, local resistance rates, and overall cost, in addition to patient-specific factors and disease presentation, to arrive at an appropriate therapy. Here, we discuss some of the challenges, such as patient/parent pressure to prescribe, lack of data or resources for implementation, and a disconnect between guidelines and real-world practice, among others. We have assembled an easy-to-use best practice guide for providers in the outpatient setting who lack the time or resources to develop a plan or consult lengthy guidelines. We provide specific suggestions for antibiotic prescribing that align real-world clinical practice with best practices for antibiotic stewardship for two of the most common bacterial infections seen in the outpatient setting: community-acquired pneumonia and skin and soft-tissue infection. In addition, we discuss many ways that community providers, payors, and regulatory bodies can make antibiotic stewardship easier to implement and more streamlined in the outpatient setting.
KW - antibiotic stewardship
KW - antimicrobial stewardship
KW - inappropriate prescribing
KW - infectious skin diseases
KW - microbial drug resistance
KW - overprescribing
KW - pneumonia
KW - therapeutic antibacterial agents
UR - http://www.scopus.com/inward/record.url?scp=85138139888&partnerID=8YFLogxK
U2 - 10.3389/fmed.2022.901980
DO - 10.3389/fmed.2022.901980
M3 - Review article
C2 - 35966853
AN - SCOPUS:85138139888
SN - 2296-858X
VL - 9
JO - Frontiers in Medicine
JF - Frontiers in Medicine
M1 - 901980
ER -