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
New to Outpatient Antimicrobial Stewardship Flyer (PDF) - Features an infographic with links to resources.
Core Elements of Outpatient Antibiotic Stewardship (CDC) - Provides guidance on creating a new stewardship program. For further information, see Core Elements Appendix A: Supplemental Evidence Supporting Outpatient Stewardship, CDC
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)
Checklists
Clinician Checklist for Outpatient Antibiotic Stewardship, CDC (PDF)
Facility Checklist for Outpatient Antibiotic Stewardship, CDC (PDF)
Posters for Patient Care Areas
Generic Poster, Provider Commitment to Stewardship Poster (PDF)
Customizable Poster, Provider Commitment to Stewardship (PowerPoint)
CDC Resources for Action
To be given to patients for whom an antibiotic may not be necessary.
Watchful Waiting for Ear Infections, CDC (PDF)
Delayed Prescribing Prescription Pads, CDC, 4.5 x 5.5 (PDF)
Delayed Prescribing Prescription Pads, CDC (PDF)
Symptom Relief Prescription Pads, CDC, 4.5 x 5.5 (PDF)
Symptom Relief Prescription Pads, CDC, 8.5 x 11 (PDF)
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
Centers for Stewardship in Medicine (formerly UW-TASP) Antibiotic Guide (UW) - Contains evidence-based antibiotic recommendations for the treatment of common diseases.
National Clinical Guidelines
Adult Outpatient Treatment Recommendations, CDC - Summarizes in a clear and concise manner the most recent recommendations for appropriate antibiotic prescribing for adults.
Pediatric Outpatient Treatment Recommendations, CDC - 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
Antibiotic Resistance and Patient Safety Portal, CDC - 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)
Antimicrobial Stewardship Quality Measures for Healthcare Professionals in Select Outpatient Settings (PDF) - 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
Training on Antibiotic Stewardship, CDC - Free continuing education opportunity for nurses and other healthcare professionals.
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
Penicillin Allergy Delabeling Newsletter Article (PDF) - A one-pager that contains statistics showing the importance of delabeling, plus links to resources to assist facilities with implementation.
Medical Provider’s FAQs about Urinary Tract Infections (PDF) - An evidence-based document that addresses some common drivers for antibiotic prescribing for asymptomatic bacteriuria (ASB)
Patient Education
Urinary Tracts in Women, YouTube Video
Questions and Feedback
Email: ams@doh.wa.gov