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Aim statement:

Reduce inappropriate antibiotic use by 20% for upper respiratory tract infection (bronchitis, sinusitis, pharyngitis) and UTI from December 2018-March 2019 compared to December 2019-March 2020.


A single center before and after intervention study using a quasi-experimental design utilizing the electronic medical records system to identify patients diagnosed with URIs or UTI in six main ambulatory care settings.

  • Inclusion criteria
    • Diagnosis of bronchitis, sinusitis, or UTI
    • Timeframe: December 1, 2018 through March 31, 2019
  • Exclusion criteria
    • Requirement for antibiotics for other indication(s)
    • Immunocompromising conditions
    • Presence of COPD, cystic fibrosis or bronchiectasis
  • The following data points were analyzed
    • Total number of antibiotics prescribed
    • Number of inappropriate antibiotic prescriptions based on:
    • Antibiotic initiation
    • Antibiotic choice
    • Antibiotic duration

Return to clinic or ED within 72 hours


  • Over half of outpatient antibiotic prescription are inappropriate
  • Initiation of antibiotics was inappropriate in 32% of the patients
  • Most patients were treated with antibiotics for more than 5-7 days

Interventions that have been implemented as of December 1, 2019

  • Clinical pathway for select disease states and order sets
  • Prospective audit and feedback on target oral antibiotics
  • Education (provider and patient)
  • Audit and Feedback

Post interventional data: Around March 31, 2020


Presented at the University of New Mexico Health Science 2020 Annual Quality Improvement and Patient Safety Symposium



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