The Take 5 Campaign: Effects of an Intervention to Promote Five-Day Durations of Antibiotic Therapy for Common Infections in Urgent Care

Abstract

Background. We implemented an intervention to promote 5-day durations of antibiotic therapy for common infections in urgent care. The objectives of this study were to evaluate the effects of this intervention on prescribed durations and clinical outcomes. Methods. This was a quasi-experimental study involving 2 urgent care centers in an integrated health care system. The Take 5 campaign was a multifaceted intervention to promote adherence to institutional guidance for 5-day durations of therapy for skin infections, urinary tract infections, sinusitis, otitis media, pneumonia, and chronic obstructive pulmonary disease exacerbations. Patients ≥18 years of age with an urgent care visit between January 2017 and December 2023 for 1 of the target infections were included. The primary outcome was the proportion of antibiotic prescriptions for ≤5 days before and after the intervention, as assessed by interrupted time-series analysis (ITS). Results. Before the intervention, there was a significant increasing trend in the proportion of prescriptions for ≤5 days. The intervention was associated with an immediate 10.7% increase in the proportion of prescriptions for ≤5 days (P < .001), with a subsequent sustained upward trend of 0.18% per month (P < .001). The aggregate proportion of prescriptions for ≤5 days increased from 57.5% before the intervention to 82.9% after implementation (P < .001). Rates of new antibiotic prescriptions and hospitalizations within 14 days were similar between the periods. Conclusions. The Take 5 campaign was associated with increased adoption of 5-day antibiotic durations. Shortening durations of therapy appears to be an effective strategy to reduce unnecessary antibiotic exposure in the urgent care setting.