The Impact of Tele-Stewardship on Rural Antibiotic Prescribing
Abstract
Matthew Peworchik MD, Department of Pediatrics, Division of Infectious Diseases, Vanderbilt [email protected]
This work was supported by an investigator-initiated QI grant through Pfizer.
Matthew Peworchik: no conflicts, Ritu Banerjee, no conflicts, Sophie Katz receives grant funding from Pfizer, serves as a consultant for Optum and a contractor for Merck.
Antibiotic prescribing is highest in rural areas. This study implemented and evaluated bundled outpatient AS interventions using tele-stewardship (AS via telecommunication with clinicians) in rural pediatric primary care clinics (PCCs) and emergency departments (EDs) affiliated with VUMC.
The bundle includes (1) patient/guardian educational materials, (2) antibiotic use commitment posters (3) provider education through quarterly teaching pearls and app-based microlearning modules (QuizTime), and (4) quarterly audit/feedback with peer comparison on guideline-concordant antibiotic use via tele-meeting and email. Participants are pediatric prescribers (physician, physician assistant, nurse practitioner). We compared antibiotic prescription data for children <18 years collected during baseline (P1) prior to the implementation of the bundle (Jan 2022–Dec 2022) to post-implementation (P2; Jan 2023-Dec 2024). The primary outcome is percent (%) of encounters with an antibiotic prescription. Secondary outcomes include (1) % of encounters with guideline-concordant antibiotic choice for otitis media (AOM), group A…
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