Intermountain Health Researchers Receive Major Grant to Study Ways to Reduce Antibiotic Overuse

Intermountain Health researchers have received a major grant to tackle the problem of antibiotic resistance and antibiotic overuse in urgent care and outpatient clinics to ensure patients are getting the best and most effective care for their illnesses.

The new $356,000 grant will be used to launch the Intermountain ReSCORE-UC project, a two-year study of behavioral and organizational methods to enhance antibiotic use in Intermountain urgent care centers and outpatient clinics.

The grant is from Merck, a global science and technology company that develops medicines, vaccines, and other health solution. It will allow Intermountain researchers to better understand how to maintain consistent improvements in antibiotic prescribing in these outpatient community settings.

The challenge for clinicians is that too high antibiotic prescription rates for respiratory infections continues to be a problem in urgent care settings. In more than 90% of cases, antibiotics don’t treat the infection for patients in these settings and can lead to sometimes serious side effects in patients, as well as overall antimicrobial resistance.

While initiatives can help lower rates and put a spotlight on the problem, the effect is often temporary, and prescribing rates creep back up when such programs end.

“In the field of antibiotic stewardship, Intermountain Health has been a national leader,” said Payal Patel, MD, enterprise medical director for antimicrobial stewardship at Intermountain Health and co-investigator on the study. “This grant will continue to put us at the forefront of understanding how we can make sure that we optimize antibiotic use in the urgent care setting to improve our prescribing rates, and also demonstrate to other health systems how they can do the same.”

“We really want to know what leads to behavior change to enhance antibiotic usage,” said Park Willis, MD, a family medicine physician at Intermountain Health who is also a co-investigator and medical director for regional urgent care for Intermountain.

“One of the key questions that we want to answer is: what processes do we need to implement that will lead to that long term effect and make it part of someone’s everyday thinking, and not just during a project?”, he added.

This new study builds off the success of the SCORE-UC initiative, a previous Intermountain study to reduce antibiotic overuse, which resulted in a 15% reduction in antibiotic prescribing for upper respiratory tract infections for patients in Intermountain Health’s 38 urgent care centers.

While that initiative was successful, the results were not permanent, and prescribing rates in these instances have ticked back up.

Across the nation, overprescribing of antibiotics is detrimental on both the individual and public health level.

“This is something that many health systems struggle with across the nation,” said Allen Seibert, MD, an infectious disease specialist at Intermountain Health and principal investigator on the study. “We’ve seen some of those antibiotic prescribing improvements be much more challenging to really maintain.”

Giving out too many antibiotics, especially in cases where they’re not needed, has led to antimicrobial resistance.

The result of overuse of antibiotics is that some previously effective antibiotic medications no longer work, which can lead to more severe infections, longer hospital stays, more complications, and even death.

Antibiotic medications are also not side-effect free for those who take them. Antibiotics can result in allergic reactions and gastric distress, which can become severe.

Given 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,” said Dr. Patel.

The new grant will also enable Intermountain researchers to study how antibiotic prescribing rates vary between different patient groups, including in racial and ethnic minorities, and in rural and urban settings.

“We can then see how we can redesign and re-implement antibiotic stewardship initiative to be more sustainable, durable, and equitable in the long term,” said Dr. Seibert.

For the study, Intermountain Health researchers will also be working with Adam Hersh, MD, a pediatric infectious disease expert at the University of Utah, and Julia Szymczak, PhD, a medical sociologist with expertise in the behavioral dynamics of antibiotic stewardship, with the aim of improving antibiotic stewardship across urgent cares in Utah and across the Intermountain West.

About Intermountain Health

Headquartered in Utah with locations in six states and additional operations across the western U.S., Intermountain Health is a nonprofit system of 33 hospitals, 385 clinics, medical groups with some 4,600 employed physicians and advanced care providers, a health plans division called Select Health with more than one million members, and other health services. Helping people live the healthiest lives possible, Intermountain is committed to improving community health and is widely recognized as a leader in transforming healthcare by using evidence-based best practices to consistently deliver high-quality outcomes at sustainable costs. For more information or updates, see https://intermountainhealthcare.org/news.