Antibiotic Prescribing Variability in a Large Urgent Care Network: A New Target for Outpatient Stewardship.
Antibiotic Prescribing Variability in a Large Urgent Care Network: A New Target for Outpatient Stewardship.
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DOI：
10.1093/cid/ciz910
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发表时间：
2020-04-10
期刊：
影响因子：
--
通讯作者：
Hersh AL
中科院分区：
文献类型：
--
作者：
Stenehjem E;Wallin A;Fleming-Dutra KE;Buckel WR;Stanfield V;Brunisholz KD;Sorensen J;Samore MH;Srivastava R;Hicks LA;Hersh AL
改善门诊场所的抗生素处方是公共卫生的优先事项。在美国，紧急护理(UC)的遭遇正在增加，不适当开抗生素的比例很高。我们的目标是描述UC期间抗生素处方的特点，重点是呼吸道情况。这是一项关于山间医疗网络中UC遭遇的回顾性队列研究。在116万次UC就诊中，34%的UC就诊期间使用了抗生素，而呼吸道疾病占所有使用抗生素的61%。50%的呼吸道接触使用了抗生素，但提供者水平上的变异性在3%到94%之间。对于没有抗生素适应症的呼吸系统疾病和鼻窦炎、中耳炎和咽炎的一线抗生素选择，供应商之间也观察到了类似的变异性。这些发现支持了制定专门针对UC环境的抗生素管理干预措施的重要性。我们描述了在一个大型的紧急护理(UC)诊所网络中开抗生素的情况。大量的传染病和供应商在抗生素处方频率和质量方面的极端差异突出了专门针对UC的抗生素管理干预的重要性。
Improving antibiotic prescribing in outpatient settings is a public health priority. In the United States, urgent care (UC) encounters are increasing and have high rates of inappropriate antibiotic prescribing. Our objective was to characterize antibiotic prescribing practices during UC encounters with a focus on respiratory tract conditions. This was a retrospective cohort study of UC encounters in the Intermountain Healthcare network. Among 1.16 million UC encounters, antibiotics were prescribed during 34% of UC encounters and respiratory conditions accounted for 61% of all antibiotics prescribed. Fifty percent of respiratory encounters received antibiotics, yet the variability at the level of the provider ranged from 3% to 94%. Similar variability between providers was observed for respiratory conditions where antibiotics are not indicated and first-line antibiotic selection for sinusitis, otitis media, and pharyngitis. These findings support the importance of developing antibiotic stewardship interventions specifically targeting UC settings. We describe antibiotic prescribing in a large network of urgent care (UC) clinics. The high volume of infectious diseases encounters and extreme provider variability in antibiotic prescribing frequency and quality highlight the importance of antibiotic stewardship interventions specifically targeting UC.
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影响因子：
39
作者：
Hersh AL;Fleming-Dutra KE;Shapiro DJ;Hyun DY;Hicks LA;Outpatient Antibiotic Use Target-Setting Workgroup
通讯作者：
Outpatient Antibiotic Use Target-Setting Workgroup
影响因子：
120.7
作者：
Fleming-Dutra, Katherine E.;Hersh, Adam L.;Hicks, Lauri A.
通讯作者：
Hicks, Lauri A.
影响因子：
120.7
作者：
Gerber, Jeffrey S.;Prasad, Priya A.;Zaoutis, Theoklis E.
通讯作者：
Zaoutis, Theoklis E.
DOI：
10.5811/westjem.2016.6.30353
发表时间：
2016-09
期刊：
The western journal of emergency medicine
影响因子：
--
作者：
Hart J;Woodruff M;Joy E;Dalto J;Snow G;Srivastava R;Isaacson B;Allen T
通讯作者：
Allen T
影响因子：
5.9
作者：
Cals, Jochen W. L.;Boumans, Dennis;Dinant, Geert-Jan
通讯作者：
Dinant, Geert-Jan