Core Elements of Outpatient Antibiotic Stewardship

Abstract

The Core Elements of Outpatient Antibiotic Stewardship provides a framework for antibiotic stewardship for outpatient clinicians and facilities that routinely provide antibiotic treatment. This report augments existing guidance for other clinical settings. In 2014 and 2015, respectively, CDC released the Core Elements of Hospital Antibiotic Stewardship Programs and the Core Elements of Antibiotic Stewardship for Nursing Homes. Antibiotic stewardship is the effort to measure and improve how antibiotics are prescribed by clinicians and used by patients. Improving antibiotic prescribing involves implementing effective strategies to modify prescribing practices to align them with evidence-based recommendations for diagnosis and management. The four core elements of outpatient antibiotic stewardship are commitment, action for policy and practice, tracking and reporting, and education and expertise. Outpatient clinicians and facility leaders can commit to improving antibiotic prescribing and take action by implementing at least one policy or practice aimed at improving antibiotic prescribing practices. Clinicians and leaders of outpatient clinics and health care systems can track antibiotic prescribing practices and regularly report these data back to clinicians. Clinicians can provide educational resources to patients and families on appropriate antibiotic use. Finally, leaders of outpatient clinics and health systems can provide clinicians with education aimed at improving antibiotic prescribing and with access to persons with expertise in antibiotic stewardship. Establishing effective antibiotic stewardship interventions can protect patients and improve clinical outcomes in outpatient health care settings.

Characteristics of Primary Care Physicians Associated With High Outpatient Antibiotic Prescribing Volume

“…This analysis demonstrates that antibiotic stewardship efforts also need to include independent and small outpatient practices, especially solo and 2-physician practices. In 2016, the CDC released the Core Elements of Outpatient Antibiotic Stewardship as a framework for antibiotic stewardship for outpatient settings, which contains recommendations that can be instituted in small, independent practices [9]. In 2016, the Quality Innovation Network–Quality Improvement Organizations (QIN-QIOs) was tasked by the Centers for Medicare and Medicaid Services to collaborate with regional partners including public health to recruit outpatient clinics serving Medicare beneficiaries and implement the CDC’s Core Elements by July 2018 [10].…”

Current State of Antimicrobial Stewardship in Children’s Hospital Emergency Departments

“…These methods for ED stewardship can be applied to other high-priority outpatient infectious diseases, including pharyngitis, otitis media, pneumonia, and upper respiratory tract infections. 42 …”

Outpatient Macrolide Antibiotic Prescribing in the United States, 2008–2011

“…However, our study suggests that macrolides may warrant a novel stewardship approach by targeting this particular class of antibiotics. The Core Elements of Outpatient Antibiotic Stewardship provides a framework for improving antibiotic prescribing, including macrolides, among both individual clinicians and organizations involved in outpatient health care [12]. Meaningful improvements in antibiotic resistance and patient safety can be made through intentional and concerted efforts aimed at optimizing antibiotic use, including macrolide antibiotics.…”