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In a quasi-experimental study involving 2 Denver Health urgent care centers, an antibiotic stewardship program known as the Take 5 Campaign increased the rates of adherence to a recommended 5-day antibiotic prescribing duration, according to a new study published in Open Forum Infectious Diseases.
“Antibiotic stewardship in urgent care is critical,” says Lindsey E. Fish, MD, study author and Editor in Chief of JUCM. “While many programs focus on decreasing inappropriate antibiotic prescribing, ensuring the appropriate dose and duration of appropriate antibiotics is also critical. Creating simple messaging for clinicians on antibiotic duration, with electronic health record support, can significantly reduce the total amount of antibiotics prescribed.”
Fish and fellow researchers evaluated the impact of promoting institutional adherence to 5-day antibiotic courses for targeted types of infections—challenging the common practice of prescribing 10-day antibiotic courses. Across 32,352 visits studied from 2017 through 2023, prescriptions for 5 days or fewer increased significantly after the campaign’s launch in 2020. Prior to the intervention, 57.5% of prescriptions were 5 days or fewer, but the percentage increased to 82.9% after the Take 5 Campaign (p<.001). Analysis showed an immediate 10.7% increase in short-course prescribing, followed by a 0.18% monthly increase. Annual antibiotic days prescribed also decreased by 21%—from 30,872 to 24,402 antibiotic days per year. Adherence to 5-day prescribing guidance increased during the intervention as follows:
- Cellulitis or skin abscess—49.9% to 78.8%
- Acute cystitis—76.7% to 86.6%
- Acute sinusitis—48.1% to 87.1%
- Acute otitis media—19.3% to 73.6%
- Pneumonia—72.0% to 93.8%
- Chronic obstructive pulmonary disease exacerbations—70.6% to 97.1%
Find it on the app: Clinical guidance for outpatient treatment of these infections is available to clinicians on an institutional antibiotic stewardship app that was launched in 2014, and it recommends 5-day antibiotic durations. The Take 5 Campaign promoted the use of the guidance with education, emails, infographics, monthly scorecards, and peer champion clinicians.
Read More
- There’s No Casual Approach to Improving Antibiotic Stewardship—but When You Make the Effort, It Works
- The Data Are in: Focusing on Antibiotic Stewardship Curbs Bad Prescribing Habits in Urgent Care