Reducing inappropriate antibiotic prescribing for patients with acne vulgaris

THE PROBLEM

Inappropriate antibiotic prescribing is defined by prescriptions that are the; incorrect choice, duration, dose or are not indicated. When prescribed inappropriately, the risk of avoidable antimicrobial resistance increases. Prescribing incentive schemes and public health agendas have prompted the practice to undertake a quality improvement project.

YOUR APPROACH

Quality improvement methodology was used to achieve the aim of reducing inappropriate antibiotic prescriptions for acne vulgaris by 10% by November 2020.  Both clinical and non-clinical staff were surveyed to aid in root cause analysis. Patients’ notes were audited according to their diagnosis, antibiotic choice, dose, duration and appropriateness for a 3 week period.  An e-mail was sent around with the current guidelines and another 3 week period was audited.

THE LEARNING

Cycle 1 showed, 5/14 patients (35%) were prescribed antibiotics inappropriately. Cycle 2 showed, 2/12 patients (16%) were incorrectly prescribed antibiotics, creating a reduction of over 50%. We can observe that our intervention has completed our aim.

WHY IT MATTERS

We intend to perform multiple PDSA cycles implementing interventions identified from our survey e.g. not putting antibiotics on a repeat prescription or informing patients they must come back for a review after a certain period of time to review their antibiotics. We hope this will encourage other healthcare practitioners to present the idea at their own practices and carry out their own quality improvement projects.

Presenting author: Dr Trupesh Patel, Irwell Medical Practice, trupesh.patel@elht.nhs.uk

Co-author: Dr Thomas Wade, Irwell Medical Practice, tom.wade@nhs.net