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Reducing Inappropriate Antibiotic Prescribing by Primary Care Clinicians

Cluster randomized trial involving nine geographically and population diverse practices to evaluate efficacy of clinical decision support tools in reducing inappropriate antibiotic prescribing in primary care for common, acute infectious conditions.

We used the DARTNet infrastructure and the Denver Health data warehouse to collect data on outpatient antibiotic use in participating primary care clinic practices (general practice, family medicine, pediatrics, internal medicine) to measure

  1.  Antibiotic prescriptions /100 visits to treat conditions for which those drugs are known not to be effective
  2. Overly broad spectrum antibiotic prescriptions /100 visits used to treat common bacterial infections.

Resulting Clinical Tools

  • Clinical Decision Support tools for Upper respiratory infection (URI)
  • Acute bronchitis
  • Pharyngitis
  • Acute Sinusitis
  • Otitis media
  • Acute cystitis
  • Cellulitis or soft tissue abscess
  • Community-acquired pneumonia (CAP)


Effects of Clinical Pathways for Common Outpatient Infections on Antibiotic Prescribing.
Jenkins TC, Irwin A, Coombs L, Dealleaume L, Ross SE, Rozwadowski J, Webster B, Dickinson LM, Sabel AL, Mackenzie TD, West DR, Price CS.
The American Journal of Medicine 2013;126(4):327-35.e12.


AHRQ Task Order Contract Number HHSA290200710008, Task Order No. 7, Task Order Leader: Connie Price.

Dataset Description

Type of Patients Included N Data Elements
All patients with a diagnosis of an acute infection 124061
  • Lab Results: New Grade 3 or 4 Abnormalities
  • Hospitalizations / ED visits (if available)
  • Diagnoses of common infections and side effects of antibiotics (ICD9 Code)
  • Duration of Therapy (In Days) (if available)
  • Prescribed Medications (NDC, Text)
  • Patient Gender
  • Patient Age