Implementing with intention: advantages, challenges, and tactics to optimally utilize the AXR metric.

Antibiotic utilization for respiratory conditions (AXR) is a new Healthcare Effectiveness Data & Information Set ^® (HEDIS^®) measure designed to complement disease-specific metrics to improve outpatient antibiotic prescribing. Unique challenges include ensuring clinicians understand the metric and establishing appropriate goals within different health systems and service lines. Successful implementation requires awareness of the metric's limitations and may be enhanced by co-reporting with condition-specific antibiotic use metrics to prioritize local interventions.