Reducing antibiotic prescribing for lower respiratory tract infections six years after a multifaceted intervention
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Reducing antibiotic prescribing for lower respiratory tract infections six years after a multifaceted intervention. / Molero, José M; Moragas, Ana; González López-Valcárcel, Beatriz; Bjerrum, Lars; Cots, Josep M; Llor, Carl.
In: International Journal of Clinical Practice, Vol. 73, No. 5, e13312, 2019.Research output: Contribution to journal › Journal article › Research › peer-review
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T1 - Reducing antibiotic prescribing for lower respiratory tract infections six years after a multifaceted intervention
AU - Molero, José M
AU - Moragas, Ana
AU - González López-Valcárcel, Beatriz
AU - Bjerrum, Lars
AU - Cots, Josep M
AU - Llor, Carl
N1 - This article is protected by copyright. All rights reserved.
PY - 2019
Y1 - 2019
N2 - AIMS: Few studies have evaluated the long-term impact of interventions on antibiotic prescription for lower respiratory tract infections (LRTI). This study was aimed at evaluating the use of antibiotics prescribed for LRTIs by general practitioners (GP) who underwent a multifaceted intervention carried out six years earlier.METHODS: GPs who had completed two registrations in 2008 and 2009 were again invited to participate in a third audit-based study in 2015. A multifaceted intervention was held one to three months before the second registration. A new group of GPs with no previous training on the rational use of antibiotics were also invited to participate and acted as controls. Multilevel logistic regression was performed considering the prescription of antibiotics as the dependent variable.RESULTS: A total of 121 GPs of the 210 who underwent the intervention (57.6%) and 117 control GPs registered 4,333 episodes of LRTIs. On adjustment for covariables, compared to the antibiotic prescription for LRTIs observed just after the intervention, antibiotic prescription slightly increased six years later among GPs who had undergone the intervention (OR 1.17, 95% CI 0.95-1.43), while control GPs prescribed significantly more antibiotics (OR 2.31, 95% CI 1.62-3.29). However, withholding antibiotic prescribing with C-reactive protein (CRP) values < 10 mg/L was more frequently observed just after the intervention compared to six years later (12.7% vs. 32.2%; p < 0.01).CONCLUSIONS: Antibiotic prescribing for LRTIs remains low six years after an intervention, although GPs are less confident to withhold antibiotic therapy in patients with low CRP levels. This article is protected by copyright. All rights reserved.
AB - AIMS: Few studies have evaluated the long-term impact of interventions on antibiotic prescription for lower respiratory tract infections (LRTI). This study was aimed at evaluating the use of antibiotics prescribed for LRTIs by general practitioners (GP) who underwent a multifaceted intervention carried out six years earlier.METHODS: GPs who had completed two registrations in 2008 and 2009 were again invited to participate in a third audit-based study in 2015. A multifaceted intervention was held one to three months before the second registration. A new group of GPs with no previous training on the rational use of antibiotics were also invited to participate and acted as controls. Multilevel logistic regression was performed considering the prescription of antibiotics as the dependent variable.RESULTS: A total of 121 GPs of the 210 who underwent the intervention (57.6%) and 117 control GPs registered 4,333 episodes of LRTIs. On adjustment for covariables, compared to the antibiotic prescription for LRTIs observed just after the intervention, antibiotic prescription slightly increased six years later among GPs who had undergone the intervention (OR 1.17, 95% CI 0.95-1.43), while control GPs prescribed significantly more antibiotics (OR 2.31, 95% CI 1.62-3.29). However, withholding antibiotic prescribing with C-reactive protein (CRP) values < 10 mg/L was more frequently observed just after the intervention compared to six years later (12.7% vs. 32.2%; p < 0.01).CONCLUSIONS: Antibiotic prescribing for LRTIs remains low six years after an intervention, although GPs are less confident to withhold antibiotic therapy in patients with low CRP levels. This article is protected by copyright. All rights reserved.
U2 - 10.1111/ijcp.13312
DO - 10.1111/ijcp.13312
M3 - Journal article
C2 - 30664320
VL - 73
JO - British Journal of Clinical Practice
JF - British Journal of Clinical Practice
SN - 1368-504X
IS - 5
M1 - e13312
ER -
ID: 212503833