The overuse of antibiotics around the world has contributed to the emergence and spread of antibiotic resistant microorganisms. Infections such as the common cold, sinusitis, otisis media, pharyngitis, bronchitis, and upper respiratory infections (URI) account for the majority of over prescribing of antibiotics. Antimicrobial resistance is ultimately associated with poorer clincial outcomes and increased health care costs. The Stevens Star Model of Knowledge of Transformation provided the evidence-based practice framework. Kurt Lewin’s organizational change theory guided the steps for the desired provider behavior change. The purpose of the project was to increase the knowledge of primary care providers regarding the most recent evidence based clinical guidelines for the management of adults with upper respiratory complaints. The education method was a power point presentation delivered to each provider’s professional email account at the clinic. Specifically, documentation of elements confirming bacterial versus viral infections were addressed as was the appropriateness of antibiotic treatment. Use of first-line rather than broad spectrum antibiotics was emphasized. Following review of the PowerPoint, providers were encouraged to reflect upon their practice patterns relating to subjective and objective data of patients with upper respiratory complaints. The desired outcomes were: 1) improved documentation of bacterial versus viral subjective and objective findings in patients with upper respiratory complaints, and 2) reduction of prescribing of broad spectrum antibiotics for upper respiratory complaints without evidence of bacterial infection. 30 charts were reviewed prior to and 28 charts reviewed following the educational program. The desired outcomes were not achieved. Documentation of required elements to support prescribing an antibiotic did not improve following the educational presentation. Additionally, and increased number of patients received inappropriate prescriptions in the post-education period. Further study is needed to determine factors that most influence provider prescribing patterns and means to influence provider behavior. Community leaders, providers and policy makers must work together to reduce the emergence and spread of drug resistance organisms that contribute to increased health care costs and morbidity.
