Antimicrobial Stewardship at Transitions of Care to Outpatient Settings: Synopsis and Strategies

Inappropriate antibiotic use and associated consequences, including pathogen resistance and Clostridioides difficile infection, continue to serve as significant threats in the United States, with increasing incidence in the community setting. While much attention has been granted towards antimicrobial stewardship in acute care settings, the transition to the outpatient setting represents a significant yet overlooked area to target optimized antimicrobial utilization. In this article, we highlight notable areas for improved practices and present an interventional approach to stewardship tactics with a framework of disease, drug, dose, and duration. In doing so, we review current evidence regarding stewardship strategies at transitional settings, including diagnostic guidance, technological clinical support, and behavioral and educational approaches for both providers and patients.

Automated summary

Inappropriate antibiotic use in the community setting is a growing concern in the United States, leading to pathogen resistance and Clostridioides difficile infection. While antimicrobial stewardship in acute care settings has received attention, optimizing antibiotic utilization in outpatient settings has been overlooked. This article highlights areas for improvement and presents an intervention approach to stewardship tactics, focusing on disease, drug, dose, and duration. Current evidence regarding stewardship strategies at transitional settings, including diagnostic guidance and behavioral and educational approaches for providers and patients, is reviewed.