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May 3, 2016

Addressing the Appropriateness of Outpatient Antibiotic Prescribing in the United StatesAn Important First Step

Author Affiliations
  • 1Johns Hopkins University School of Medicine, Division of Pediatric Infectious Diseases, Department of Pediatrics, Baltimore, Maryland
  • 2Johns Hopkins University School of Medicine, Department of Medicine, Division of Infectious Diseases, Baltimore, Maryland
JAMA. 2016;315(17):1839-1841. doi:10.1001/jama.2016.4286

The statement “If you cannot measure it, you cannot improve it,” attributed to Lord Kelvin, is of particular relevance to the field of antibiotic stewardship. Whereas the plea for optimizing how antibiotics are used in the United States has been ongoing for more than 50 years, improvement has been slow. This is particularly a concern in the outpatient setting, where the majority of antibiotics are prescribed, but where widespread stewardship efforts have had limited success.1,2 A focus on expanding antibiotic stewardship in the outpatient setting has been recommended by the Presidential Advisory Council on Combating Antibiotic-Resistant Bacteria in its recent report, in which developing approaches to obtain prescriber-level data on appropriate antibiotic use and developing mechanisms to provide direct feedback on performance are highlighted as important issues.3

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