Category: Federal Forum Posters
Purpose: Cough is a leading illness-related reason for ambulatory care visits in the United States, and in these patients, acute bronchitis is the most common diagnosis. Acute bronchitis is a predominantly viral illness, and according to clinical practice guidelines, should not be treated with antibiotics. Despite guideline recommendations, patients continue to receive antibiotics, which are ineffective, cause adverse effects, and contribute to antibiotic resistance, resulting in the increase of morbidity and mortality of treatable infections. The objective of this project is to improve the rate of inappropriate antibiotic prescribing in patients diagnosed with acute bronchitis in order to improve patient care.
Methods: This project will be submitted to the Institutional Review Board for approval. The electronic health record will identify patients who have been diagnosed with acute bronchitis and received antibiotics. The following data will be collected: patient name, patient chart number, primary diagnosis of acute bronchitis, primary diagnosis date of visit, additional diagnoses for that date of visit, medications prescribed for that date of visit, and prescriber. Prescriber notes will be reviewed to determine reason for potentially inappropriate antibiotic prescribing, such as a diagnosis of chronic lung disease or an acute condition that warrants antibiotics. All patient identifiers will be removed when data collection is complete and maintained in a secure setting and on a secure server. Patients who received antibiotics for a diagnosis of acute bronchitis in the absence of an additional acute condition that warrants antibiotics or chronic lung disease will be reviewed and included in the quality improvement study. We will then implement an antibiotic stewardship program involving education and an audit-feedback approach for prescribers. Following this, we will review antibiotic prescribing for acute bronchitis diagnoses to evaluate if antibiotic prescribing rates improved.
Results: not applicable
Conclusion: not applicable
Colleen D'Amico– Pharmacy Resident, Yakama Indian Health Center, Yakima, WA