Sterling Infectious Diseases
Stewardship Program

Outpatient Antibiotic Stewardship

Board-certified infectious disease specialists providing culture follow-up and antibiotic optimization after ER and urgent care visits. Right antibiotic, right dose, right duration.

Why Outpatient Stewardship?

Cultures obtained in emergency departments and urgent care centers often result after the patient has been discharged on empiric antibiotics. Without structured follow-up, these results may go unreviewed—leading to continued inappropriate therapy, missed resistant organisms, or unnecessary antibiotic exposure.

Evidence shows that structured culture review leads to antibiotic changes in 20-40% of cases, improving outcomes and reducing resistance.

Stewardship Activities

1
Culture Follow-UpReview of cultures obtained in ER, urgent care, or outpatient settings with therapy optimization.
2
Antibiotic De-escalationNarrowing broad-spectrum antibiotics based on culture results and clinical response.
3
IV-to-Oral ConversionTransitioning appropriate patients from IV to oral antibiotics with equivalent efficacy.
4
Duration OptimizationEvidence-based antibiotic duration recommendations to minimize resistance and side effects.

Submit for Stewardship Review

Post-ER VisitER Culture Follow-Up

For patients discharged from ER with pending cultures

Post-Urgent CareUrgent Care Follow-Up

For patients seen at urgent care with pending cultures

Frequently Asked Questions

What cultures qualify for stewardship review?

Any culture obtained in an outpatient setting—urine, wound, blood, respiratory—can be reviewed. We prioritize cultures with positive results or those where the initial empiric therapy may need adjustment.

How quickly will cultures be reviewed?

We aim to review cultures within 48 hours of receiving the referral and culture results. Urgent cases with concerning findings are prioritized.

Do you contact the patient directly?

Our default is to communicate recommendations to the referring provider, who then contacts the patient. However, we can contact patients directly if the referring provider prefers.

Is there a charge for stewardship review?

Depending on the complexity, stewardship services may be billed as a consultation. We verify insurance coverage and communicate any expected patient responsibility before proceeding.

References: CDC Core Elements of Outpatient Antibiotic Stewardship (2021). IDSA/SHEA Antimicrobial Stewardship Guidelines.