Improving Antibiotic Prescribing Practices: A Quality Improvement Project

Background: Antibiotic stewardship is critical to combating resistance. Our Quality Improvement Project (QIP) aimed to evaluate and enhance antibiotic prescribing practices across three DME wards by assessing guideline adherence, therapy duration, end date documentation, and concurrent proton pump inhibitor (PPI) use.  Older adults are at higher risk of antibiotic associated complications, especially C. diff infection.

Methods: Baseline data were collected from the hospital's electronic prescribing system, evaluating prescriptions for indication appropriateness, duration compliance, documentation of therapy end dates, and PPI co-prescription. An educational intervention (intervention 1: poster highlighting prescriber responsibilities, intervention 2: educational talk on the topic) was implemented, followed by repeat audits to measure impact. Data were analysed quantitatively using percentage adherence to metrics and qualitatively via prescriber feedback.

Results:

After the first intervention, adherence to prescribing guidelines improved by 3%(65% to 68%), therapy end-date documentation increased by 9%(75% to 84%), and unjustified PPI co-prescriptions decreased by 7%(50% to 43%). Following the second intervention, adherence improved by an additional 4% (68% to 72%), therapy end-date documentation increased by 1% (84% to 85%), and unjustified PPI co-prescriptions decreased by 10% (43% to 33%).

Conclusion: Targeted educational interventions effectively improved antibiotic prescribing practices. Further cycles will focus on sustaining and building upon these improvements to optimize antimicrobial stewardship.

Implications: This QIP demonstrates the impact of simple, structured interventions in promoting responsible antibiotic use and reducing risks of resistance.

Referances: CDC. Core elements of hospital antibiotic stewardship programs.
Atlanta (GA): Centers for Disease Control and Prevention; 2019.