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Antibiotic Prescribing In the Urgent Care

Mizuho Morrison, DO and Mike Weinstock, MD
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A study recently published in JAMA Internal Medicine by Palms et al, demonstrated that urgent cares are overprescribing antibiotics more than any other clinical setting. We need to do a better job of antibiotic stewardship, and Mike and Miz tackle HOW.

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Kevin O. -

Lets talk about how to remove patient satisfaction from healthcare...that alone is increasing resistance as "providers" try to move the meat. We know prescribing more antibiotics increases resistance. We also know a poor review more immediately affects our jobs than the 20 years it takes to develop resistance.

Mike W., MD -

Check out this article: Fenton et al. Arch Int Med 2011

Susan M. -

"My wife was just sick with the same thing I have and she came here and got a Z-pak and was better in a couple of days."
"I have already tried saline nasal spray, antihistamines, Alkaseltzer Cold / Flu, Sudafed, (name another OTC med here) for my sinus pressure x 3-4 days and NONE of them are working! I need an antibiotic".
"I am afraid this cold is going to move down into my chest causing bronchitis and I want to knock it out before that happens. I usually get a prescription for (name your respiratory antibiotic here)".
Most of our patients have it in their head they are are leaving with an antibiotic come hell or high water. I have tried to discuss the difference between viral and bacterial until I am blue in the face and ways to help them feel better with less risk and more often than not, get a stony response, poor review (I don't care any more I am so burned out.....), or a request to never see me again (okay - that was only one person). Our patients have co-pays ranging from $20 - $75. They DO NOT want to have to come back. My fall back has become the delay-fill antibiotic and I hate it.

Rana R. -

That's is what I have resorted to when they have high co pays and or I tell them to call if they are not improving in x-x days during which time I will be back in the clinic. i.e. I see them on a tuesday and tell them to call back on Saturday

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You'll Shoot Your Eye Out! Full episode audio for MD edition 189:20 min - 89 MB - M4AHippo UC RAP October 2018 Written Summary 394 KB - PDF