2074. A Successful Acute Respiratory Tract Infection Campaign to Improve Antibiotic Prescribing in Outpatient Clinics and an Emergency Department

BACKGROUND: Acute Respiratory tract infections (ARI) are infections involving the upper respiratory tract. Most ARIs are viral in nature and self-limited in which most of the times antibiotic treatment is unnecessary. A recent VA medication utilization evaluation conducted in 28 medical centers identified high rates of unnecessary antibiotic prescribing for ARI. Based on these analyses the VA National Academic Detailing Service (VANADS) created the ARI campaign, providing materials for VA systems to employ as the seek to improve ARI management. Our project consists of implementation of the ARI Campaign in a South Florida Veteran Affairs HealthCare System (Miami VAHS). METHODS: We utilized VANADS resources for our campaign. Activities included assessing ARI prescribing patterns, garnering stakeholder support, identifying pharmacist and physician champions, providing targeted academic detailing, handing out provider ARI guidance documents (in paper and electronically), disseminating provider-specific feedback with peer comparison, order-set development with advertisement, promoting appropriate coding, and reporting to the Miami VAHS antimicrobial stewardship program (ASP) subcommittee. Campaign activities were initiated in October 2017. The ARI Campaign was selected as the priority item for FY-2019, from our annual ASP risk assessment with a goal of reducing antibiotic prescribing for ARI diagnosis to below 40%. We present the data up to March 2019. RESULTS: Baseline data from October 2015 through September 2017 revealed an antibiotic was prescribed to 1,651 of 2,843 (58%) encounters in which an ARI diagnosis was made in our system. In the months following ARI Campaign initiation, a decline in antibiotic prescribing for ARI diagnosis was found. In the most recent quarter (January–March 2019), the prescribing rate was 39%. Figure 1 shows system-wide vs. Florida region prescribing rates. Table 1 provides data by major site and for the top 10 priority providers we identified. CONCLUSION: Implementation of a multifaceted ARI Campaign at a single-center resulted in a substantial reduction in antibiotic prescriptions. Future work is warranted investigating which activities are most impactful for reducing unnecessary antibiotic prescribing for ARI. [Image: see text] [Image: see text] DISCLOSURES: All authors: No reported disclosures.