Clinical Study
Antibiotic Stewardship in Urgent Care: How Next-Morning Diagnostics Are Reshaping Clinical Decision-Making
HealthTrackRx • Published: May 27, 2026 • Last Reviewed: May, 2026
Antibiotic stewardship in urgent care has reached an inflection point. High patient volume, diagnostic uncertainty, and patient expectations continue to drive inappropriate prescribing, especially for respiratory conditions. At the same time, advances in molecular diagnostics and operational playbooks are enabling a more precise, scalable approach to care.
A recent UCA Solutions Webinar, “Antibiotic Stewardship in Urgent Care: An Operator and Medical Director Playbook,” outlines the scope of the problem and how leading organizations are tackling this challenge with data, diagnostics, and system-level change.
The Core Problem: Speed + Uncertainty = Overprescribing
Urgent care sits at the center of outpatient antibiotic use and misuse.
- Up to 50% of outpatient antibiotic prescribing is inappropriate, largely driven by respiratory conditions1
- 60% of bronchitis visits result in antibiotics, despite being largely viral2
- 47% of patients report receiving antibiotics without testing3
Vasudha Gupta, PharmD, emphasizes the scale and urgency, “Antibiotic stewardship remains a critical quality and safety objective for ambulatory care clinicians.”
The challenge is not simply clinical; it is structural. Urgent care providers must make rapid decisions in:
- Single-visit encounters
- High-throughput environments
- Limited access to real-time diagnostic data
As a result, empiric prescribing becomes the default.
Diagnostic Uncertainty Is the Inflection Point
At the heart of inappropriate prescribing is one issue: uncertainty.
Dr. Steven Goldberg, MD, MBA, frames it directly: “Diagnostic uncertainty is one of the biggest drivers of cost, poor outcomes, and inefficiency in ambulatory infectious disease complaints.”
When clinicians lack clarity on the underlying pathogen, they are more likely to:
- Prescribe “just in case”
- Default to broad-spectrum antibiotics
- Reinforce patient expectations for antibiotics
This creates a cycle of overuse, resistance, and downstream harm.
Why Traditional Approaches Fall Short
Even well-intentioned stewardship efforts often rely on:
- Education alone
- Retrospective feedback
- Static guidelines
While important, these approaches do not solve the real-time decision problem in the exam room.
As Dr. Goldberg explains, “Managing patients with less than complete information is suboptimal and drives avoidable downstream costs.”
The implication is clear: better decisions require better data, faster.
The Shift: Diagnostics as a Stewardship Tool
Modern stewardship is moving upstream, into the clinical workflow itself.
Vasudha Gupta highlights the evolving role of diagnostics: “Molecular testing diagnostic insights can be considered a component of the continuum to support antibiotic stewardship.”
What’s changing?
Instead of asking “Should I prescribe?”, clinicians can now ask:
- What pathogen is present?
- Is this viral or bacterial?
- Can I confidently defer antibiotics?
The impact of next-morning diagnostics:
- Reduces diagnostic uncertainty
- Enables targeted, guideline-aligned therapy
- Supports “wait and see” decisions with confidence
- Improves patient communication and trust
Evidence shows that integrating diagnostics into care can reduce inappropriate prescribing and improve overall utilization
Shared Decision-Making: Aligning Clinical Confidence with Patient Expectations
Diagnostics also enable a critical behavioral shift: shared decision-making (SDM).
According to the webinar:
- SDM can reduce antibiotic prescribing by 25–50% in respiratory infections4
- Patient satisfaction remains stable or improves
Dr. Goldberg explains the practical value, “Shared decision making can be helpful when expectations are misaligned and when the clinician needs to say no to antibiotics without saying no to the patient.”
This is particularly important in urgent care, where perceived patient expectations are a major driver of prescribing.
Scaling Stewardship: From Individual Decisions to System-Level Change
Effective stewardship requires more than individual clinician behavior. It requires infrastructure.
Dr. Sarika Aggarwal, MD, MHCM, describes the operational approach: “I am excited to share the why, what, and how of a successful implementation of antibiotic stewardship in a multi-state and site urgent and primary care organization.”
Key components of scalable stewardship programs:
- Clinical decision support in EMR
- Standardized treatment protocols
- Provider education and case-based training
- Performance measurement and feedback loops
- Patient education tools and scripts
These interventions are not theoretical. Real-world results show:
- ~48% reduction in inappropriate antibiotics for bronchitis5
- ~33% reduction for viral URTIs among engaged clinicians5
The Clinical Reality: A Common Urgent Care Scenario
Consider a typical respiratory visit:
A patient presents with a cough and requests antibiotics based on prior experience.
Traditional approach:
- Quick exam
- Antibiotic prescribed “to be safe”
Stewardship-driven approach:
- Clarify patient concerns
- Explain viral course (2–3 weeks typical)
- Use diagnostics if uncertainty remains
- Provide symptom management plan
Outcome:
- No unnecessary antibiotics
- Patient remains satisfied
- Expectations reset for future visits
The Opportunity: Reducing Uncertainty at Scale
The largest opportunity in urgent care stewardship is not simply reducing prescribing. It is reducing uncertainty.
As summarized in the webinar:
- Urgent care is a high-impact setting due to volume and variability
- Diagnostic uncertainty is the primary driver of overprescribing
- Diagnostics and workflows together enable confident, appropriate care
Dr. Goldberg reinforces this shift, saying, “This is not about testing more. It’s about testing smarter.”
What This Means for Urgent Care Leaders
For operators, CMOs, and clinical leaders, the path forward is clear:
1. Integrate diagnostics into the care pathway
Not as an add-on, but as a core decision-making tool.
2. Enable next-morning clinical clarity
Faster answers drive better prescribing behavior.
3. Align workflows, education, and incentives
Stewardship must be operationalized, not just encouraged.
4. Empower clinicians with confidence
Confidence reduces variability, improves outcomes, and strengthens patient trust.
Final Takeaway
Antibiotic stewardship in urgent care is no longer just about reducing prescriptions. It is about enabling better decisions, faster.
Diagnostics, when combined with structured workflows and shared decision-making, are redefining what high-quality care in urgent care looks like.
And ultimately, that shift supports the goal that matters most:
Getting patients the right treatment, at the right time, with confidence.
References
- Centers for Disease Control and Prevention. Antibiotic Resistance Threats in the United States, 2019. US Department of Health and Human Services; 2019.
- Grigoryan L, et al. Antibiotic prescribing for uncomplicated respiratory tract infections in ambulatory care. Antibiotics (Basel). 2017;6(4):E20. doi:10.3390/antibiotics6040020 (Note: title inferred based on commonly cited Grigoryan 2017 Antibiotics paper; adjust if using a different article.)
- HealthTrack. Respiratory Season Insights: Testing, Antibiotic Use & First Care. HealthTrack Population Study; December 2025.
- Diagnostics and decisions: molecular test insights in shared decision-making for managing respiratory infections. J Particip Med. 2025;17:e81968. doi:10.2196/81968
- Park DE, Roberts ALS, Hamdy RF, Balthrop S, Dolan P, Liu CM. Evaluating an urgent care antibiotic stewardship intervention: a multi-network collaborative effort. Infect Control Hosp Epidemiol. 2025;46(3):266-271. doi:10.1017/ice.2024.213
References
- Centers for Disease Control and Prevention. Antibiotic Resistance Threats in the United States, 2019. US Department of Health and Human Services; 2019.
- Grigoryan L, et al. Antibiotic prescribing for uncomplicated respiratory tract infections in ambulatory care. Antibiotics (Basel). 2017;6(4):E20. doi:10.3390/antibiotics6040020 (Note: title inferred based on commonly cited Grigoryan 2017 Antibiotics paper; adjust if using a different article.)
- HealthTrack. Respiratory Season Insights: Testing, Antibiotic Use & First Care. HealthTrack Population Study; December 2025.
- Diagnostics and decisions: molecular test insights in shared decision-making for managing respiratory infections. J Particip Med. 2025;17:e81968. doi:10.2196/81968
- Park DE, Roberts ALS, Hamdy RF, Balthrop S, Dolan P, Liu CM. Evaluating an urgent care antibiotic stewardship intervention: a multi-network collaborative effort. Infect Control Hosp Epidemiol. 2025;46(3):266-271. doi:10.1017/ice.2024.213
Related Articles and White papers
HealthTrackRx • Published: May 27, 2026 • Last Reviewed: May, 2026
Antibiotic stewardship in urgent care has reached an inflection point. High patient volume, diagnostic uncertainty, and patient expectations continue to drive inappropriate prescribing, especially for respiratory conditions. At the same time, advances in molecular diagnostics and operational playbooks are enabling a more precise, scalable approach to care.
A recent UCA Solutions Webinar, “Antibiotic Stewardship in Urgent Care: An Operator and Medical Director Playbook,” outlines the scope of the problem and how leading organizations are tackling this challenge with data, diagnostics, and system-level change.
The Core Problem: Speed + Uncertainty = Overprescribing
Urgent care sits at the center of outpatient antibiotic use and misuse.
- Up to 50% of outpatient antibiotic prescribing is inappropriate, largely driven by respiratory conditions1
- 60% of bronchitis visits result in antibiotics, despite being largely viral2
- 47% of patients report receiving antibiotics without testing3
Vasudha Gupta, PharmD, emphasizes the scale and urgency, “Antibiotic stewardship remains a critical quality and safety objective for ambulatory care clinicians.”
The challenge is not simply clinical; it is structural. Urgent care providers must make rapid decisions in:
- Single-visit encounters
- High-throughput environments
- Limited access to real-time diagnostic data
As a result, empiric prescribing becomes the default.
Diagnostic Uncertainty Is the Inflection Point
At the heart of inappropriate prescribing is one issue: uncertainty.
Dr. Steven Goldberg, MD, MBA, frames it directly: “Diagnostic uncertainty is one of the biggest drivers of cost, poor outcomes, and inefficiency in ambulatory infectious disease complaints.”
When clinicians lack clarity on the underlying pathogen, they are more likely to:
- Prescribe “just in case”
- Default to broad-spectrum antibiotics
- Reinforce patient expectations for antibiotics
This creates a cycle of overuse, resistance, and downstream harm.
Why Traditional Approaches Fall Short
Even well-intentioned stewardship efforts often rely on:
- Education alone
- Retrospective feedback
- Static guidelines
While important, these approaches do not solve the real-time decision problem in the exam room.
As Dr. Goldberg explains, “Managing patients with less than complete information is suboptimal and drives avoidable downstream costs.”
The implication is clear: better decisions require better data, faster.
The Shift: Diagnostics as a Stewardship Tool
Modern stewardship is moving upstream, into the clinical workflow itself.
Vasudha Gupta highlights the evolving role of diagnostics: “Molecular testing diagnostic insights can be considered a component of the continuum to support antibiotic stewardship.”
What’s changing?
Instead of asking “Should I prescribe?”, clinicians can now ask:
- What pathogen is present?
- Is this viral or bacterial?
- Can I confidently defer antibiotics?
The impact of next-morning diagnostics:
- Reduces diagnostic uncertainty
- Enables targeted, guideline-aligned therapy
- Supports “wait and see” decisions with confidence
- Improves patient communication and trust
Evidence shows that integrating diagnostics into care can reduce inappropriate prescribing and improve overall utilization
Shared Decision-Making: Aligning Clinical Confidence with Patient Expectations
Diagnostics also enable a critical behavioral shift: shared decision-making (SDM).
According to the webinar:
- SDM can reduce antibiotic prescribing by 25–50% in respiratory infections4
- Patient satisfaction remains stable or improves
Dr. Goldberg explains the practical value, “Shared decision making can be helpful when expectations are misaligned and when the clinician needs to say no to antibiotics without saying no to the patient.”
This is particularly important in urgent care, where perceived patient expectations are a major driver of prescribing.
Scaling Stewardship: From Individual Decisions to System-Level Change
Effective stewardship requires more than individual clinician behavior. It requires infrastructure.
Dr. Sarika Aggarwal, MD, MHCM, describes the operational approach: “I am excited to share the why, what, and how of a successful implementation of antibiotic stewardship in a multi-state and site urgent and primary care organization.”
Key components of scalable stewardship programs:
- Clinical decision support in EMR
- Standardized treatment protocols
- Provider education and case-based training
- Performance measurement and feedback loops
- Patient education tools and scripts
These interventions are not theoretical. Real-world results show:
- ~48% reduction in inappropriate antibiotics for bronchitis5
- ~33% reduction for viral URTIs among engaged clinicians5
The Clinical Reality: A Common Urgent Care Scenario
Consider a typical respiratory visit:
A patient presents with a cough and requests antibiotics based on prior experience.
Traditional approach:
- Quick exam
- Antibiotic prescribed “to be safe”
Stewardship-driven approach:
- Clarify patient concerns
- Explain viral course (2–3 weeks typical)
- Use diagnostics if uncertainty remains
- Provide symptom management plan
Outcome:
- No unnecessary antibiotics
- Patient remains satisfied
- Expectations reset for future visits
The Opportunity: Reducing Uncertainty at Scale
The largest opportunity in urgent care stewardship is not simply reducing prescribing. It is reducing uncertainty.
As summarized in the webinar:
- Urgent care is a high-impact setting due to volume and variability
- Diagnostic uncertainty is the primary driver of overprescribing
- Diagnostics and workflows together enable confident, appropriate care
Dr. Goldberg reinforces this shift, saying, “This is not about testing more. It’s about testing smarter.”
What This Means for Urgent Care Leaders
For operators, CMOs, and clinical leaders, the path forward is clear:
1. Integrate diagnostics into the care pathway
Not as an add-on, but as a core decision-making tool.
2. Enable next-morning clinical clarity
Faster answers drive better prescribing behavior.
3. Align workflows, education, and incentives
Stewardship must be operationalized, not just encouraged.
4. Empower clinicians with confidence
Confidence reduces variability, improves outcomes, and strengthens patient trust.
Final Takeaway
Antibiotic stewardship in urgent care is no longer just about reducing prescriptions. It is about enabling better decisions, faster.
Diagnostics, when combined with structured workflows and shared decision-making, are redefining what high-quality care in urgent care looks like.
And ultimately, that shift supports the goal that matters most:
Getting patients the right treatment, at the right time, with confidence.
References
- Centers for Disease Control and Prevention. Antibiotic Resistance Threats in the United States, 2019. US Department of Health and Human Services; 2019.
- Grigoryan L, et al. Antibiotic prescribing for uncomplicated respiratory tract infections in ambulatory care. Antibiotics (Basel). 2017;6(4):E20. doi:10.3390/antibiotics6040020 (Note: title inferred based on commonly cited Grigoryan 2017 Antibiotics paper; adjust if using a different article.)
- HealthTrack. Respiratory Season Insights: Testing, Antibiotic Use & First Care. HealthTrack Population Study; December 2025.
- Diagnostics and decisions: molecular test insights in shared decision-making for managing respiratory infections. J Particip Med. 2025;17:e81968. doi:10.2196/81968
- Park DE, Roberts ALS, Hamdy RF, Balthrop S, Dolan P, Liu CM. Evaluating an urgent care antibiotic stewardship intervention: a multi-network collaborative effort. Infect Control Hosp Epidemiol. 2025;46(3):266-271. doi:10.1017/ice.2024.213
References
- Centers for Disease Control and Prevention. Antibiotic Resistance Threats in the United States, 2019. US Department of Health and Human Services; 2019.
- Grigoryan L, et al. Antibiotic prescribing for uncomplicated respiratory tract infections in ambulatory care. Antibiotics (Basel). 2017;6(4):E20. doi:10.3390/antibiotics6040020 (Note: title inferred based on commonly cited Grigoryan 2017 Antibiotics paper; adjust if using a different article.)
- HealthTrack. Respiratory Season Insights: Testing, Antibiotic Use & First Care. HealthTrack Population Study; December 2025.
- Diagnostics and decisions: molecular test insights in shared decision-making for managing respiratory infections. J Particip Med. 2025;17:e81968. doi:10.2196/81968
- Park DE, Roberts ALS, Hamdy RF, Balthrop S, Dolan P, Liu CM. Evaluating an urgent care antibiotic stewardship intervention: a multi-network collaborative effort. Infect Control Hosp Epidemiol. 2025;46(3):266-271. doi:10.1017/ice.2024.213
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