Miller School Takes Action to Manage Antibiotic Use in Outpatient Settings

Through an innovative outpatient antimicrobial stewardship program, the University of Miami Miller School of Medicine is taking action to manage antibiotics appropriately.

From left, Juan M. Vidal, RN, with Jose G. Castro, M.D.

“At least 30 percent of outpatient antibiotic prescriptions are unnecessary,” said Jose G. Castro, M.D., medical director of the University of Miami Medical Group Infection Control Department. “Physicians and patients need to understand the importance of using antibiotics judiciously.”

To improve antibiotic stewardship in the community, the Miller School is collaborating with Health Services Advisory Group (HSAG), the Medicare Quality Innovation Network-Quality Improvement Organization for Florida.

“Antibiotic resistance has been identified by the Centers for Disease Control and Prevention (CDC) as a fundamental aspect of global health concern,” said HSAG President and CEO Mary Ellen Dalton, Ph.D., M.B.A., RN.

“Through this collaboration, we will work to implement CDC-recommended protocols and best practices to combat antibiotic resistance,” she added. “Together, we will strengthen our pledge to establish antibiotic stewardship activities that are effective and sustainable and continue our commitment to patient safety.”

Recognizing the importance of combating antibiotic resistance, the CDC has designated November 13–19 as U.S. Antibiotic Awareness Week, an annual observance that focuses on appropriate prescribing and use.

Several years ago, the Centers for Medicare & Medicaid Services and partners such as HSAG began focusing on managing antibiotic use in hospital settings. Last year, that objective was expanded to include physician offices, health clinics, emergency departments, urgent care facilities, pharmacies and other outpatient settings.

“We began working with HSAG on this collaborative initiative in March,” said Juan M. Vidal, RN, an infection preventionist and antimicrobial stewardship program staff champion for UHealth – the University of Miami Health System. “Since then, we’ve taken several steps, including sharing patient videos in English and Spanish, tracking antibiotic use, and providing evidence-based feedback to prescribers.”

For example, Vidal is helping to develop an antibiogram that will provide real-time information to clinicians on the resistance and suitability of antibiotics for various types of bacterial or other microbial infections.

“This will be a big step forward in providing appropriate prescriptions in an outpatient setting,” he said. “We want to ensure that the right drug, dose, and duration are selected when an antibiotic is needed.”

To date, the Miller School stewardship program has received positive feedback from clinical leaders, said Castro. “Many divisions and departments have asked us to get in the trenches with their clinicians and to cover this topic in grand rounds so physicians in training are aware of this worldwide patient safety issue.”

Tags: antibiotics, antimicrobial stewardship, Health Services Advisory Group, Jose Castro, Juan Vidal, Miller School of Medicine, UHealth - the University of Miami Health System, University of Miami