Intermountain Health has received two different grants to study how to reduce antibiotic overuse in urgent care and outpatient clinics and also funding to help advance care for children by improving antibiotic prescribing practices for acute respiratory tract infection. The first is a grant for $356,000 to launch the Intermountain ReSCORE-UC project. The second is a $2.5 million funding award by the Patient-Centered Outcomes Research Institute (PCORI). 

“They are two different grants to optimize antibiotic use,” said Payal Patel, MD, enterprise medical director of antimicrobial stewardship at Intermountain Health and co-investigator on the ReSCORE-UC study. “We’re trying to improve the whole time between a patient coming in and leaving with the right diagnosis. Antibiotics won’t help if it’s not bacteria. We want to make sure the right thing happens.”

The previous SCORE-UC initiative done by Intermountain Health to reduce antibiotic overuse was successful but prescribing rates started ticking back up.

“We want to make sure that it’s equitable throughout the system so that it will keep going in the years ahead,” said Patel. “We’re trying to understand sustainability in antibiotic stewardship which has mostly been in hospitals.”

This is newer on the outpatient side, she said. “We’re studying how it can be sustained and spread to other systems as well. It will take quite a bit of work to understand.”

It’s a common myth that patients ask for antibiotics, Patel said. “Actually, they just want what will make them feel better. This will provide doctors the tools to say ‘here is what you have and here is what will help.’ It makes it easier on patients and the prescriber.”

From the last work in this space, Intermountain built a dashboard where they could see what was prescribed across the state, Patel said. “We’ve had access to it in our own clinics to guide us on how we can help and talk more about health equity in the world of antibiotics and use that data so that patients know what’s going on no matter where they see us.”

Patel said that more than 90% of respiratory infections are caused by viruses and not bacteria. “Giving these patients antibiotics won’t help and rather just give you another side effect like diarrhea.”

Intermountain received a $2.5 million grant from PCORI in October. “It goes live in 2025,” said Patel. “It's a research project to improve antibiotic use in children through all systems. It’s outpatient facilities like an ER, urgent care, pediatrician – any place a parent and child might come in to see us. It’s a four year study throughout the whole system that will hit multiple states.”

“This project represents a significant springboard from which we can improve the care for more than 270,000 children with acute respiratory tract infections by promoting the adoption of evidence-based antibiotic prescribing practices throughout our system,” said Raj Srivastava, MD, chief clinical programs officer for Intermountain Health, who is leading the project.

“We look forward to the opportunity this initiative holds to continue to improve our clinical practices, and especially, enhance the health outcomes for hundreds of thousands of children who we provide care for,” Srivastava added.

 PCORI is an independent, nonprofit organization authorized by Congress with a mission to fund patient-centered comparative clinical effectiveness research that provides patients, their caregivers, and clinicians with the evidence-based information they need to make better-informed health and health care decisions, according to Intermountain.

“Intermountain Health is leading the way in antimicrobial stewardship,” said Patel. “No matter where you see us we are doing our best to treat infection in the best way possible.” λ