UHF Outpatient Initiative on Antibiotic Prescribing for Acute Respiratory Infections Shows Need for Antibiotic Stewardship Programs

A review of more than 1,000 New York City patient records from 31 hospital-owned outpatient practices, collected as part of the UHF-funded Outpatient Antibiotic Stewardship Initiative, illustrates the need for robust antibiotic stewardship programs. The study, published September 18 in the journal Infection Control & Hospital Epidemiology, found that doctors prescribed antibiotics for nearly 67 percent of patients who had acute bronchitis and more than 80 percent for acute sinusitis, even though antibiotics are not usually indicated for these conditions.

Overall, 37.3 percent of patients were prescribed antibiotics for acute respiratory infections (ARIs), with the range of prescribing rates by site varying widely. The team surveyed the practices from nine hospitals and health systems about current antibiotic stewardship programs, and found that prior to the participating in the collaborative only 11 percent of the practices had any outpatient-specific activities on antibiotic stewardship.

The study was authored by Joan Guzik, Pooja Kothari, and Misha Sharp, all part of the antibiotic stewardship initiative at UHF; Gopi Patel, MD, MS, associate professor and director of antibiotic stewardship at The Mount Sinai Hospital; and Belinda Ostrowsky, MD, medical field officer for the division of health care quality and promotion at the Centers for Disease Control and Prevention. It was undertaken to determine baseline data for outpatient antibiotic prescribing during the first phase of UHF’s antibiotic stewardship initiative. The second phase, completed earlier this year, worked with 34 hospital-affiliated practices from seven health care systems to develop, implement, and measure impact among antibiotic stewardship interventions to improve prescribing for adults with ARIs.  

The abstract and full, final version of the study, published September 18, can be accessed here: