cdc out patient antibiotic report

In 2014 and 2015, respectively, CDC released the Core Elements of Hospital Antibiotic Stewardship Programs 21,22 and the Core Elements of Antibiotic Stewardship for Nursing Homes. 23 This 2016 report, Core Elements of Outpatient Antibiotic Stewardship, provides guidance for antibiotic stewardship in outpatient settings and is applicable to any entity interested in improving outpatient antibiotic prescribing and use.

Full Answer

Where do the data for outpatient antibiotic prescriptions come from?

These data represent all outpatient antibiotic prescriptions from community pharmacies from all payers but exclude federal facilities. Provider specialties are taken from the American Medical Association (AMA) self-designated practice specialties, DEA and NPI sources and categorized into one of 17 groups.

Are antibiotic prescriptions declining among patients with Uri?

A follow-up analysis of Medicaid claims and pharmacy data identified a decrease in antibiotic prescribing over time, both among adult (18+ years old) and pediatric (3 months to 17 years old) populations. Fewer adults who were seen for acute URI had antibiotics prescribed in 2017 (37.4 per 100 visits) when compared to 2010 (46.5 per 100 visits).

How did aware identify the highest 20% of antibiotic prescribers?

AWARE partnered with 10 large health plans across California to identify the highest 20% of antibiotic prescribers by volume. Each high prescriber was mailed a curated stewardship packet that included a cover letter, educational resources, and the AWARE toolkit.

Did outpatient antibiotic prescribing decline in 2020?

” were presented during the Presidential Advisory Council on Combating Antibiotic-Resistant Bacteria (PACCARB) meeting on September 9-10, 2020. Preliminary data suggest that outpatient antibiotic prescribing decreased during April and May 2020 compared with the same time period in 2019.

When will the CDC continue to lead the effort to improve antibiotic use in humans?

efforts to improve antibiotic use in humans, as outlined in the new National Action Plan for Combatting Antibiotic-Resistant Bacteria, 2020-2025. pdf icon.

What is the Antibiotic Resistance and Patient Safety Portal?

The Antibiotic Resistance and Patient Safety Portal is a resource to explore and visualize data on outpatient antibiotic prescribing, hospital antibiotic stewardship implementation, antibiotic resistance, and healthcare-associated infections.# N#Explore here: https://arpsp.cdc.gov/

How does Henry Ford Health System improve antibiotics?

Henry Ford Health System, a Detroit -based integrated non-profit health system with six hospitals across southeast Michigan, developed an innovative process to improve the use of antibiotics at hospital discharge. The Antimicrobial Stewardship (AMS) team previously identified prolonged antibiotic therapy at discharge to be a challenge. The AMS Transitions of Care (TOC) process was implemented in November 2018 to optimize antimicrobial drug selection, dose, and duration at hospital discharge for patients with uncomplicated infections. The AMS TOC process at Henry Ford Health System is led by AMS pharmacists and clinical pharmacy staff practicing on the patient care wards. The pharmacists work with bedside nurses to identify patients likely to be discharged on oral antibiotics and collaborate with physicians to apply local guidelines for appropriate drug therapy and total duration. The pharmacists prepare the discharge prescription in the electronic medical record, including the appropriate stop date, and assess for barriers to medication access. The strategy demonstrated an improvement in optimal discharge antibiotics from 36% before to 77% after implementation. Patients receiving optimal antibiotics were also less likely to experience adverse drug events.

What are the core elements of antibiotic stewardship?

CDC’s Core Elements of Hospital Antibiotic Stewardship provide a framework for implementation of antibiotic stewardship programs. Partners across the country are using the Core Elements to guide antibiotic stewardship efforts in hospital settings. The Core Elements form the foundation for antibiotic stewardship accreditation standards from the Joint Commission and DNV-GL. The 2019 hospital Conditions of Participation from the Centers for Medicare and Medicaid Services (CMS) created a federal regulation for hospital antibiotic stewardship programs and also reference the Core Elements. This map shows the percentage of hospitals meeting all 7 Core Elements, by state, in 2019. CDC continues to improve assessment of the quality of antibiotic stewardship programs in hospitals.

Why is the CDC promoting antibiotic stewardship?

Together with the Get Ahead of Sepsis educational effort, CDC is promoting the importance of antibiotic stewardship to ensure appropriate and timely antibiotic use in sepsis management. Antibiotics can save lives and are critical tools for treating infections, including those that can lead to sepsis.

How does the CDC work?

CDC works to improve antibiotic use by collecting, analyzing, and publishing data to support antibiotic stewardship efforts in state and local health departments, in healthcare facilities, and by individual prescribers.

Why is antibiotic stewardship important?

Antibiotic stewardship, or improving how antibiotics are prescribed and used, is critical for optimizing treatment of patients who have infections, protecting patients from harm, and combating antibiotic resistance. In 2019, the Centers for Disease Control and Prevention (CDC) released “ Antibiotic Use in the United States, ...

Summary

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.

Introduction

Antibiotic resistance is among the greatest public health threats today, leading to an estimated 2 million infections and 23,000 deaths per year in the United States.

Background

Improving antibiotic prescribing in all health care settings is critical to combating antibiotic-resistant bacteria. 7 Approximately 60% of U.S. antibiotic expenditures for humans are related to care received in outpatient settings. 8 In other developed countries, approximately 80%–90% of antibiotic use occurs among outpatients.

Methods

CDC’s Core Elements of Outpatient Antibiotic Stewardship were developed through a combination of consolidating evidence-based antibiotic stewardship practices and building on or adapting known best practices for antibiotic stewardship across other clinical settings, such as the core elements outlined for hospitals 21,22 and nursing homes.

Core Elements of Outpatient Antibiotic Stewardship

The Core Elements of Outpatient Antibiotic Stewardship follow and are summarized in a clinician checklist pdf icon [PDF – 2 pages] and a facility checklist pdf icon [PDF – 2 pages].

Commitment

A commitment from all health care team members to prescribe antibiotics appropriately and engage in antibiotic stewardship is critical to improving antibiotic prescribing. Every person involved in patient care, whether directly or indirectly, can act as an antibiotic steward.

Action for Policy and Practice

Outpatient clinicians and clinic leaders can implement policies and interventions to promote appropriate antibiotic prescribing practices. A stepwise approach with achievable goals can facilitate policy and practice changes and help clinicians and staff members from feeling overwhelmed.

Why is it important to prescribe antibiotics?

Improving the way we prescribe and use antibiotics, or “antibiotic stewardship,” is critical to effectively treat infections, protect patients from harms caused by unnecessary antibiotic use, and combat antibiotic resistance.

What is the CDC working to promote?

Antibiotic Prescribing and Use in the U.S. Stewardship Reports. minus. Related Pages. CDC is working to promote appropriate antibiotic use by helping prescribers use the right antibiotic, at the right dose, for the right duration, and at the right time, and reduce unnecessary antibiotic use.

Is the United States making progress in antibiotic use?

The United States has made some progress in improving antibiotic prescribing and use in human health , but many opportunities remain. Current Stewardship Report: Antibiotic Use in the United States: Progress and Opportunities. Past Antibiotic Prescribing and Use Reports.

What is antibiotic prescribing?

Antibiotic prescribing guidelines establish standards of care and focus quality improvement efforts. The table also offers information related to over-the-counter medication for symptomatic therapy. Over-the-counter medications can provide symptom relief, but have not been shown to shorten the duration of illness.

How long does it take to get rid of a GAS antibiotic resistance?

GAS antibiotic resistance to azithromycin and clindamycin are increasingly common. Recommended treatment course for all oral beta lactams is 10 days. Acute uncomplicated cystitis 10, 11. Cystitis is among the most common infections in women and is usually caused by E. coli.

What is the only indication for antibiotic therapy for sore throat?

Providers and patients must weigh the benefits and harms of symptomatic therapy. Group A beta-hemolytic streptococcal (GAS) infection is the only common indication for antibiotic therapy for sore throat cases. Only 5–10% of adult sore throat cases are caused by GAS.

How many cases of rhinosinusitis in 2012?

About 1 out of 8 adults (12%) in 2012 reported receiving a diagnosis of rhinosinusitis in the previous 12 months, resulting in more than 30 million diagnoses. Ninety–98% of rhinosinusitis cases are viral, and antibiotics are not guaranteed to help even if the causative agent is bacterial.

What are the most accurate indicators of acute uncomplicated cystitis?

Hematuria and suprapubic discomfort are less common. Nitrites and leukocyte esterase are the most accurate indicators of acute uncomplicated cystitis. For acute uncomplicated cystitis in healthy adult non-pregnant, premenopausal women:

How long does it take for a viral infection to worsen?

Worsening (3-4 days) such as worsening or new onset fever, daytime cough, or nasal discharge after initial improvement of a viral upper respiratory infections (URI) lasting 5-6 days. Sinus radiographs are not routinely recommended.

Can you take antibiotics with negative RADT?

Throat cultures are not routinely recommended for adults. Antibiotic treatment is NOT recommended for patients with negative RADT results. Amoxicillin and penicillin V remain first-line therapy due to their reliable antibiotic activity against GAS.

What is tracking and reporting antibiotic prescribing?

Tracking and reporting clinician antibiotic prescribing, also called audit and feedback, can guide changes in practice and be used to assess progress in improving antibiotic prescribing. Both clinicians and clinic leaders can be involved in antibiotic stewardship. Clinicians can track and report their own antibiotic prescribing practices by doing at least one of the following:

What is antibiotic stewardship?

Although the core elements provide a framework for outpatient antibiotic stewardship, implementing the elements requires a thoughtful and consistent effort to achieve desired outcomes. This includes developing strategies and preparing individuals, facilities, or organizations for change; developing and testing stewardship interventions; identifying and addressing barriers to change; and evaluating progress toward stated goals. Outpatient settings remain a crucial component of antibiotic stewardship in the United States. Establishing effective antibiotic stewardship interventions can protect patients and optimize clinical outcomes in outpatient health care settings.

What is the core element of antibiotic stewardship?

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.

Methods

• CDC’s Core Elements of Outpatient Antibiotic Stewardship were developed through a combination of consolidating evidence-based antibiotic stewardship practices and building on or adapting known best practices for antibiotic stewardship across other clinical settings, such as the core elements outlined for hospitals21,22 and nursing homes.23 A narrat...

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CORE Elements of Outpatient Antibiotic Stewardship

Commitment

Action For Policy and Practice

Tracking and Reporting

Education and Expertise

Future Directions

Conclusion

Acknowledgements