Official websites use. Share sensitive information only on official, secure websites. For commercial re-use, please contact journals. The Centers for Disease Control and Prevention advocates for the display of commitment posters in outpatient clinics for healthcare providers to pledge to only prescribe antibiotics when a bacterial infection is suspected.
However, their impact on antibiotic prescribing in the outpatient setting has largely been part of multi-faceted interventions in academic medical centers or urban cities rather than in rural settings. The objective of this study was to determine the impact of commitment posters as a single-intervention in rural outpatient clinics on antibiotic prescribing for upper respiratory tract infections URIs.
This was a quasi-experimental study performed at The Guthrie Clinic, a network of outpatient clinics located in rural New York and Pennsylvania. Patients with a URI visit diagnosis code during the period of July 1, βDecember 31, pre-intervention and July 1, βDecember 31, post-intervention were included. Demographic, provider, clinic, and antibiotic prescription data were collected. A total of 4, and 3, URI cases were diagnosed, and antibiotics were prescribed for 2, and 1, cases in the pre- and post-intervention periods, respectively.
Fewer antibiotics were prescribed for URI cases in the post-intervention period compared with pre-intervention The most commonly prescribed antibiotics in both cohorts were amoxicillin, amoxicillinβclavulanate, and azithromycin.
There was no statistically significant difference in antibiotics prescribed for patients with and without certain comorbidities such as diabetes or chronic obstructive pulmonary disease. Antibiotic stewardship commitment posters were associated with a decrease in the number of antibiotics prescribed for URIs in rural clinics and represent a low-hanging fruit intervention for outpatient antibiotic stewardship programs, particularly in rural settings.
