Key Takeaways: Advancing Antimicrobial Stewardship in Outpatient Care
By the bioMérieux Editors | Reading time: 2 min
PUBLICATION DATE: June 25, 2026
Antimicrobial stewardship (AMS) is well established in hospitals, but most antibiotic prescribing occurs in outpatient settings. In the latest episode of AMR Pathways: From Challenge to Change, Gail Harrell, MSN, RN, Medical Science Liaison at bioMérieux, and Dr. Rebekah Howell Wrenn, PharmD, BCIDP, Duke University Hospital, discussed why ambulatory care is a critical front in the fight against antimicrobial resistance (AMR) and shared practical strategies for improving antibiotic use in the community.
You can watch the full episode by clicking below.
AMR Pathways Season 2, Episode 2: Key Takeaways
Why Outpatient Stewardship Matters
Approximately 60% of antibiotic prescriptions in the United States are written in ambulatory settings, including primary care, urgent care, retail clinics, and emergency departments. Studies suggest that nearly one-third of these prescriptions may be unnecessary or suboptimal, particularly for common respiratory infections.
Inappropriate antibiotic use is not without consequences. Unnecessary prescribing can contribute to adverse drug events, C. difficile infections, increased healthcare costs, and the development of AMR. Because antibiotic exposure drives resistance, every avoidable prescription represents an opportunity to improve patient safety and preserve treatment options for the future.
Unique Challenges in Ambulatory Care
Outpatient AMS presents challenges that differ from those seen in hospitals. Clinicians often face:
- Diagnostic uncertainty
- Time constraints during patient visits
- Perceived patient expectations for antibiotics
- Fragmented follow-up and care transitions
- Limited access to prescribing and outcomes data
These realities make it essential to create workflows, tools, and communication strategies that support appropriate prescribing while maintaining efficiency and patient satisfaction.
The Role of Diagnostics and Communication in AMS
Appropriate diagnostic testing can reduce uncertainty and support more confident treatment decisions. When combined with clinical decision support and effective patient communication, diagnostics can help clinicians distinguish between viral and bacterial infections, avoid unnecessary antibiotic use, and improve patient understanding of treatment plans.
AMS conversations should focus not only on why antibiotics may not be needed, but also on what clinicians can do to help patients feel better and know when to seek additional care.
Measuring What Matters
Successful AMS programs do not require complex analytics. Organizations can begin by tracking practical metrics such as:
- Antibiotic prescriptions per visit or provider
- Prescribing rates for conditions where antibiotics are rarely indicated
- Use of broad-spectrum antibiotics
- Duration of therapy compared with guideline recommendations
- Follow-up visits and patient outcomes
The goal is to establish a sustainable feedback loop that helps identify opportunities for improvement over time.
Practical AMS Interventions
Several AMS strategies can be implemented with minimal resources, including:
- Standardized patient communication tools
- Delayed prescribing or safety-net approaches
- Guideline-based EHR order sets and prescribing defaults
- Clinic-wide AMS goals and progress reporting
These interventions can help make appropriate prescribing the easier choice while supporting both clinicians and patients.
A Call to Action
Outpatient AMS is a shared responsibility across healthcare disciplines. Whether you are a clinician, microbiologist, pharmacist, nurse, infection preventionist, or public health professional, small changes can have a meaningful impact.
By combining diagnostics, education, data, and collaboration, healthcare teams can improve antibiotic use, enhance patient care, and help preserve the effectiveness of antibiotics for future generations.
Delve deeper into these insights and real-world examples shared by watching the full episode.
