P-644. Antibiotic Prescription Rate for Viral Respiratory Infections After a Viral Care Package Intervention and Provider Education in the Urgent Care Setting

TL;DR

A viral care package and provider education reduced antibiotic prescriptions for viral infections in urgent care.

Contribution

A provider-driven intervention with education and care packages reduced inappropriate antibiotic use for viral infections.

Findings

Antibiotic prescriptions for Tier 3 infections dropped from 13.9% to 9.1% after the intervention.

The reduction was mainly due to fewer prescriptions for acute bronchitis in the intervention group.

Patient satisfaction with the care package was high, averaging 9.6 out of 10.

Abstract

Antibiotics are often prescribed for patients diagnosed with Tier 3 viral respiratory infections (e.g., acute bronchitis, upper respiratory tract infections), despite strong recommendations against their use. The aim of this study was to assess if the implementation of a viral care package plus a one-time provider education (VCP+E) was associated with a reduction in antibiotic prescriptions for Tier 3 infections in the urgent care (UC) setting.

Viral care packages (VCPs) with over-the-counter products were made for one Munson Healthcare UC and developed into four age-appropriate packages for patients 2 years and older. They were dispensed from 11/1/2024-1/31/2025 following a provider education session on the appropriate use of antibiotics for Tier 3 infections. Patients diagnosed with a Tier 3 infection only were eligible to receive a VCP. Outcomes were assessed pre (10/1/2023-4/30/2024) and post (2/1/2025-4/30/2025) VCP+E implementation. The primary outcome assessed antibiotic prescription rate for patients with Tier 3 infections, compared to a combined group of 3 UCs without VCP+E. Secondary outcomes assessed antibiotic prescription rate for all encounters, rate of antibiotic prescriptions within 7 days of receiving a VCP, and patient and provider satisfaction through a survey.

379 VCPs were dispensed during the study timeframe. The rate of antibiotic prescriptions for Tier 3 infections was lower after VCP+E implementation (13.9 vs. 9.1%, p< 0.001), with no change in the group without VCP+E during the same time period (35.2 vs. 37.2%, p=0.529). This change was largely driven by a reduction in prescriptions for acute bronchitis in the VCP+E group (44.1 vs. 25%, p< 0.001). Overall rate of antibiotic prescriptions for any indication was higher in both groups after implementation (VCP+E= 30.4 vs. 34.1%, p < 0.001; no E+VCP= 41.8 vs. 45.9%, p< 0.001). Within 7 days of receiving a viral care package, 7.9% of patients received an antibiotic. Approximately 10% (n=36) of patients who received a VCP responded to a survey with average patient satisfaction being 9.6/10.

A provider-driven VCP intervention plus a one-time provider education was associated with a decrease in antibiotic prescriptions for Tier 3 respiratory infections in the UC setting.

All Authors: No reported disclosures