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A study of urgent care centers published in Open Forum Infectious Diseases found that medication-dispensing kiosks, combined with an antimicrobial stewardship program, could be useful to support antibiotic stewardship principles. In late 2019, a Florida health system installed medication kiosks in 20 of its urgent care centers, providing prepackaged antibiotics corresponding to guideline-supported antibiotic courses. Instead of sending a patient’s prescription to a community pharmacy, for example, the urgent care clinician could send the electronic prescription to the kiosk, allowing the patient to obtain the medication at the urgent care location. Researchers then compared 38,593 antibiotic prescriptions ordered from January –June 2019 (preimplementation period) with 45,608 antibiotic prescriptions ordered from January–June 2024 (postimplementation period). When compared, the average antibiotic duration decreased from 8.4 days before the kiosks were available to 7.8 days per prescription after the kiosks were available, an 8% reduction, with an estimated 33,340 fewer antibiotic days of therapy in 2024, according to the authors.
Pushing the right buttons: What’s interesting is that the clinicians could use the kiosk’s inventory as a prescribing default. For example, the nitrofurantoin package was changed from 14 tablets (a 7-day course) to 10 tablets (a “guideline-supported” 5-day course), and average nitrofurantoin treatment duration subsequently fell from about 7 days to about 5 days. The authors emphasize that kiosks should not be viewed only as a convenience for patients and providers. As it turns out, medication quantities and inventory contained in the kiosks can influence prescribing choices. They conclude that early and ongoing antimicrobial stewardship involvement in kiosk inventory decisions may help encourage guideline adherence.