Getting Started
According to the CDC, 30% of outpatient antibiotic prescriptions in the United States are unnecessary (Core Elements of Antibiotic Stewardship for Nursing Homes, CDC). Approximately half of outpatient antibiotic prescribing in humans might be inappropriate.
Patients who are unnecessarily exposed to antibiotics are placed at risk for those adverse events with no benefit. By reducing unnecessary antibiotic prescribing, antimicrobial stewardship programs can prevent avoidable adverse events resulting from antibiotics.
The resources below are designed to assist all outpatient healthcare professionals with implementing a program.
Implementation Guidance
- CDC's Core Elements of Outpatient Antibiotic Stewardship
- Provides guidance on creating a new stewardship program
- For further information, see also CDC’s Core Elements Appendix A: Supplemental Evidence Supporting Outpatient Stewardship
- Prescribing Appropriate Antibiotics for Acute Respiratory Conditions (PAAARC) Toolkit
- Guidance for implementation of antimicrobial stewardship interventions surrounding acute respiratory conditions in outpatient clinic settings (adapted from the MITIGATE Antimicrobial Stewardship Toolkit)
- PAAARC Recruitment Packet
- Learn how your organization can apply for funding to implement the PAAARC Toolkit
- Up to 2 healthcare organizations will be selected based upon the criteria
- 2+ primary care or urgent care clinics within their network
- Electronic medical record system with IT support for report extraction capability
PAAARC Application
Checklists
- Clinician Checklist for Outpatient Antibiotic Stewardship
- Facility Checklist for Outpatient Antibiotic Stewardship
Posters
To post in patient care areas
- WA DOH Provider Commitment to Stewardship Posters:
CDC Resources for Action
To be given to patients for whom an antibiotic may not be necessary
- Watchful Waiting for Ear Infections
- Delayed Prescribing Prescription Pads:
- Symptom Relief Prescription Pads:
Clinical Guidance
Local Clinical Guideline Creation Guidance Document
- Best Practices for Creating Local Antimicrobial Stewardship Clinical Practice Guidelines in Healthcare Settings (PDF)
- Created in partnership with the University of Washington’s Centers for Stewardship in Medicine (UW-CSiM), this document assists facilities with creating local guidelines
Antibiotic Treatment Guide
- UW’s Centers for Stewardship in Medicine (formerly UW-TASP) Antibiotic Guide
- Contains evidence-based antibiotic recommendations for the treatment of common diseases
National Clinical Guidelines
- CDC’s Adult Outpatient Treatment Recommendations
- Summarizes in a clear and concise manner the most recent recommendations for appropriate antibiotic prescribing for adults
- CDC’S Pediatric Outpatient Treatment Recommendations
- Summarizes in a clear and concise manner the most recent recommendations for appropriate antibiotic prescribing for pediatrics
- IDSA Practice Guidelines
- Guidelines for common disease states such as pneumonia, skin infections, and urinary tract infections
- GOLD Guidelines for COPD
- An evidence-based strategy document for COPD management
Data
CDC’s Antibiotic Resistance and Patient Safety Portal (ARSP)
- Allows healthcare providers, facilities, and the public to explore and visualize national and state-specific data relevant to both outpatient and inpatient antibiotic stewardship programs
HEDIS Measures - Washington Community Checkup
- Displays Health Effectiveness Data and Information Set (HEDIS) measure scores by county, accountable community of health, and state average
- Measures related to antibiotic prescribing include:
- Avoidance of Antibiotics for Acute Bronchitis (AAB)
- Appropriate Treatment for Upper Respiratory Infection (URI)
- Appropriate Testing for Pharyngitis (CWP)
- Contains a list of quality measures that are applicable to antimicrobial stewardship programs in urgent care clinics, family practice clinics, and more
Education
Specialized Training and Educational Opportunities
- CDC Training on Antibiotic Stewardship
- Free continuing education opportunity for nurses and other healthcare professionals
- Making A Difference in Infectious Diseases (MAD-ID) Certificate Programs
- Designed to help practitioners who are currently or planning to pursue antimicrobial stewardship activities.
- Society of Infectious Diseases Pharmacists (SIDP) Certificate Programs
- This program provides education on the healthcare provider’s role in using antimicrobials wisely
Educational Documents for All Clinicians
- WA DOH’s Penicillin Allergy Delabeling Newsletter Article
- A one-pager that contains statistics showing the importance of delabeling, plus links to resources to assist facilities with implementation
- WA DOH’s Medical Provider’s FAQs about Urinary Tract Infections (UTI)
- An evidence-based document that addresses some common drivers for antibiotic prescribing for asymptomatic bacteriuria (ASB)
Educational Documents for Community Pharmacists
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- Discusses ways in which community pharmacists can assist with antimicrobial stewardship efforts