Urgent care providers wrestle with decisions about antibiotic prescribing every day. It’s not made any easier by patients who plead for a script, either. Some guidance, or at least validation, might be drawn from a new Viewpoint piece published in the Journal of the American Medical Association, however. It analyzes concepts put forth by the Agency for Healthcare Research and Quality, identifying four “moments” in which clinicians should ask themselves certain questions about each patient’s illness and the nature of their treatment:

  1. Does this patient have an infection that requires antibiotics?
  2. Have I ordered appropriate cultures before starting antibiotics? And what empirical antibiotic therapy should I initiate?
  3. A day has passed. Can I stop antibiotics? Can I narrow therapy? Can I change from intravenous to oral therapy?
  4. What duration of antibiotic therapy is needed for this patient’s diagnosis?

Given that so many patients flock to urgent care centers specifically to ask for an antibiotic at the first twinge of a sore throat or earache, breaking down a given encounter into these moments can be a mindful reminder of the true purpose and value of antibiotics, as well as the importance of saying No when they aren’t warranted. JUCM has examined one approach that’s specific to urgent care in Delayed Prescribing of Antibiotics for Respiratory Tract Infections. You can read it here.

Recognize Antibiotic Decision Points to Help Stem Resistance
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