The majority of all antimicrobial use (estimated 80-90%) occurs in the outpatient setting. Per the Centers for Disease Control and Prevention (CDC), at least 30% of antibiotics prescribed in US doctor’s offices and emergency departments are still unnecessary. Using antibiotics wisely, without them losing effectiveness, may be even more delicate in the emergency and urgent care settings.
Similar to the inpatient hospital setting, treatment of bacterial infections makes antibiotics invaluable. However, the majority of infectious disease conditions in the outpatient setting are caused by viral infections for which antibiotics have no effect. Overprescribing of antibiotics has led to a worldwide problem with antibiotic resistant bacteria. Furthermore, side effects from antibiotics, such as affecting other bacteria in the body or adverse reactions, are common.
Antibiotic stewardship efforts in the emergency and urgent care setting help balance the need for effective treatment of bacterial infections while reducing prescribing for viral illnesses. Emergency and urgent care clinicians and facilities can provide educational resources to patients and families, as well as track antibiotic prescribing habits of clinicians to provide feedback to them on effective prescribing that encourages change.
The MITIGATE Toolkit is an emergency department and urgent care stewardship toolkit that providers can utilize when implementing antimicrobial stewardship strategies in emergency department and urgent care settings.