Problem: Approximately one-third of outpaJent anJbioJc prescripJons in the United States are unnecessary, contribuJng to anJbioJc resistance and increased healthcare costs. In a primary care office in Western Maryland, 33% of adults aged 18 and older diagnosed with acute bronchiJs and upper respiratory infecJons received anJbioJcs from September to December 2023. These infecJons are typically viral and self-limited, making anJbioJcs unnecessary unless a secondary bacterial infecJon occurs. Purpose: The purpose of this quality improvement (QI) project was to reduce anJbioJc prescribing and improve treatment efficacy for acute bronchiJs and upper respiratory infecJons in adults by implemenJng and measuring a Clinical Decision Support (CDS) tool embedded within the Electronic Health Record (EHR), an evidence-based pracJce change. Methods: The 15-week intervenJon occurred in Fall 2024. In week one, staff training was completed with three advanced pracJce providers, two physicians, seven medical assistants (MAs), and one office manager (OM). The CDS tool (an Encounter Plan) was launched in the EHR for paJents 18 and older with acute bronchiJs or upper respiratory symptoms in the second week of implementaJon. MAs acJvated the tool, automaJng CDC recommendaJons and paJent handouts in the "Assessment and Plan." Providers used this informaJon to guide anJbioJc prescribing decisions. This project impacted approximately 5,800 paJents and 13 healthcare providers within this primary care office. Results: There were 176 paJent encounters for acute bronchiJs and upper respiratory infecJons. Compliance with the encounter plan ranged from 45% (n=11) in week 10 to 86% (n=7) in week 2, with an average compliance rate of 69%. AnJbioJc prescribing rates ranged from 13% (n=1) in week 3 to 60% (n=12) in week 11, with an overall average prescribing rate of 33%. Conclusions: Encounter plan compliance was 69% of the 100% goal. The 0% anJbioJc prescribing goal was not met, with an average rate of 33%. The intervenJon demonstrated a reducJon of immediate prescribing through the wait-and-see strategy. The adjusted anJbioJc prescribing rate was 22%, excluding wait-and-see and pneumonia prescripJons for confirmed cases via chest X-ray. Findings suggest the encounter plan is a feasible implementaJon to improve anJbioJc stewardship in primary care.