Department of Public Health - Acute Communicable Disease Control

Targeting Appropriate Prescribing in Outpatient Settings (TAP OUT)

Inappropriate antibiotic use is the primary contributor to the spread of antibiotic resistance. Estimates are that more than 30 percent of antibiotics prescribed in outpatient settings are unnecessary. Primary care clinics and clinicians prescribe approximately half of all outpatient antibiotics in the United States. Outpatient antibiotic prescribing in particular has been demonstrated to be directly associated with antimicrobial resistance. Antimicrobial stewardship efforts have been shown to be effective to combat inappropriate antimicrobial prescribing, growing microbial resistance, and increasing costs. LACDPH designed its Targeting Appropriate Prescribing in Outpatient Settings (TAP OUT) program to assist ambulatory healthcare settings in Los Angeles County meet the CDC Core Elements of Stewardship through implementation of evidence-based practices.

Outpatient Antibiotic Stewardship Training
- Antibiotic Stewardship in the Outpatient Setting SLIDES
- Tools to Curb Inappropriate Use of Antibiotics SLIDES
- Appropriate Treatment of Common Infections in Primary Care SLIDES

Guidelines

Title Description

CDC Core Elements of Outpatient Antibiotic Stewardship The Core Elements of Outpatient Antibiotic Stewardship provides a framework for antibiotic stewardship for outpatient clinicians and facilities that routinely provide antibiotic treatment.

Quality Improvement Organizations Field Guide to Antibiotic Stewardship in Outpatient Settings This Guide provides a collection of concrete implementation strategies, suggestions, and tools designed, tested, and applied by QIN-QIOs working with a variety of outpatient settings to implement the Core Elements.

Washington State Department of Health EQuIP for Ambulatory Care Clinics The purpose of this JumpStart workbook is to provide ambulatory clinics with guidance and tools to plan, implement and maintain a feasible, sustainable ASP tailored to their own unique resources and characteristics.

MITIGATE Toolkit for Emergency Departments and Urgent Care Settings This guide outlines how facilities can implement individualized, effective, and practical antimicrobial stewardship programs in acute care (emergency department and urgent care) settings.

Publications
2017 Special Report: Using CDC’s Core Elements of Outpatient Stewardship to improve antibiotic prescribing practices in Los Angeles County
Public Health Quarterly Connect (for outpatient settings)

External Resources
Health Services Advisory Group Outpatient Antibiotic Stewardship
Physicians for a Healthy California Project AWARE