Are quality improvement strategies to improve outpatient antibiotic use effective?
Our review found that the vast majority of published studies reported clinically significant improvements in antibiotic treatment and selection. The magnitude of these effects compares favorably to those achieved by quality improvement efforts in other settings. These findings were consistent across diverse patient populations and clinical settings. More than half the included studies were performed in the last decade; the concomitant decline in antibiotic prescribing in US ambulatory practices suggests that efforts to promote judicious antibiotic use are succeeding. However, inappropriate prescribing rates remain high, and inappropriate selection of antibiotics presents a continuing challenge. In addition to benefiting patients and the community by reducing the adverse consequences of inappropriate antibiotic use, effective interventions may result in cost savings, although definitive evidence is lacking.
