Leveraging an antimicrobial stewardship collaborative and urgent care center medication-dispensing kiosks to support shorter antibiotic durations: a multi-site, retrospective evaluation

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ID: 328986
2026
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Abstract
Abstract Background Outpatient medication dispensing kiosks that contain antibiotics are proliferating. This study aimed to evaluate how their implementation in urgent care centers (UCC) alongside antimicrobial stewardship program (ASP) collaborative engagement can influence antibiotic prescribing. Methods This retrospective cohort study included 20 UCCs, evaluating antibiotic electronic prescriptions (eRX) ordered in January - June 2019 (pre-period) versus January - June 2024 (post-period). In late-2019 kiosks containing antibiotics were placed into UCCs with initial kiosk inventories based off historical eRx volumes. Serendipitously an outpatient ASP collaborative was established around the same time. Between the pre-/post-periods numerous programmatic interventions were implemented to promote rational antibiotic prescribing, including kiosk inventory modifications, education, and stakeholder engagement. Data on eRx prescribing for 12 antibiotics were obtained. The primary outcome was antibiotic duration of therapy (DOT) in days per eRx. Secondary outcomes included antibiotic-specific changes, kiosk utilization, and an estimate of intervention impact. Findings In the pre-period 38,593 eRx were included with 325,400 DOTs, as compared to 45,608 eRx with 355,502 DOTs in the post-period (8.4 DOT/prescription versus 7.8 DOT/prescription, respectively, p < 0.001). In the pre-period 8,649 eRx (22%) were routed to a kiosk compared to 25,414 eRx (56%) in the post-period, p < 0.001. There was an estimated 33,340 DOT avoided in the post-period. Interpretation Engagement of an antimicrobial stewardship collaborative along with implementation of UCC kiosks containing antibiotics may support prescriber practices that align with stewardship principles and safer outpatient antibiotic use. For health systems considering kiosk adoption, early and sustained ASP involvement in inventory decisions appears critical, which this manuscript may serve to support as a template.
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Authors Timothy P. Gauthier, Ethan A Lobo, Corey M Frederick, Harrison Phan, Lauren Russell, Michael DeCoske, Richard Levine, Yenny Ceballos, Ernesto Sanz-Martinez
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Journal Open forum infectious diseases
Year 2026
DOI
10.1093/ofid/ofag508
URL
https://doi.org/10.1093/ofid/ofag508
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