[Utilisation of first-line antibiotics six years after a multifaceted intervention].

Uso de antibióticos de primera línea 6 años después de una intervención multifacética.

Publisher: Sociedad Española de Quimioterapia Country of Publication: Spain NLM ID: 9108821 Publication Model: Print-Electronic Cited Medium: Internet ISSN: 1988-9518 (Electronic) Linking ISSN: 02143429 NLM ISO Abbreviation: Rev Esp Quimioter Subsets: MEDLINE

Publication: [Barcelona] : Sociedad Española de Quimioterapia
Original Publication: Barcelona : J.R. Prous, S.A., [1988-

Antimicrobial Stewardship* ; Drug Utilization*; Anti-Bacterial Agents/*therapeutic use ; Bacterial Infections/*drug therapy ; Bacterial Infections/*epidemiology; Drug Prescriptions ; Humans ; Practice Patterns, Physicians' ; Registries ; Respiratory Tract Infections/drug therapy ; Respiratory Tract Infections/epidemiology ; Respiratory Tract Infections/microbiology ; Spain/epidemiology

Objective: No study has evaluated the impact of a multifaceted intervention on the quality of the antibiotics prescribed more than 5 years later.
Methods: A total of 210 general practitioners (GP) from eight different regions of Spain were asked to participate in two registrations of respiratory tract infections (RTI) in 2008, before, and in 2009, just after a multifaceted intervention including prescriber feedback, clinical guidelines, training sessions focused on appropriate antibiotic prescribing, workshop on rapid tests and provision of these tests in the GP consultation. They were all again invited to participate in a similar registration in 2015. A new group of clinicians from the same areas who had never participated in antimicrobial stewardship courses were also invited to participate and acted as controls.
Results: The 121 GPs who continued the study (57.6%) and the 117 control GPs registered 22,407 RTIs. The antibiotic most commonly prescribed was amoxicillin and clavulanic acid, prescribed in 1,801 cases (8.1% of the total), followed by amoxicillin (1,372 prescriptions, 6.2%), being lower among GPs just after the intervention. The third leading antibiotic among GPs just after the intervention was penicillin V (127 cases, 3.3%) whereas macrolides ranked third in the other three groups of GPs.
Conclusions: The use of first-line antibiotic for RTIs wanes over time after an intervention, but their utilisation is still significantly greater among intervened clinicians six years later compared to GPs who have never been exposed to any antimicrobial stewardship programmes.
(©The Author 2018. Published by Sociedad Española de Quimioterapia. This article is distributed under the terms of the Creative Commons Attribution-NonCommercial 4.0 International (CC BY-NC 4.0)(https://creativecommons.org/licenses/by-nc/4.0/).)

Eur J Gen Pract. 2015 Mar;21(1):12-8. (PMID: 25112148)
Lancet. 2005 Feb 12-18;365(9459):579-87. (PMID: 15708101)
Scand J Prim Health Care. 1999 Sep;17(3):185-90. (PMID: 10555250)
J Antimicrob Chemother. 2018 Aug 1;73(8):2215-2222. (PMID: 29718420)
BMJ. 2013 Jul 26;347:f4403. (PMID: 23894178)
JAMA. 2016 Feb 9;315(6):562-70. (PMID: 26864410)
Br J Gen Pract. 2012 Dec;62(605):e801-7. (PMID: 23211259)
Enferm Infecc Microbiol Clin. 2010 Apr;28(4):222-6. (PMID: 19720435)
Aten Primaria. 2015 Oct;47(8):532-43. (PMID: 26025360)
BMC Fam Pract. 2011 Jun 20;12:52. (PMID: 21689406)

0 (Anti-Bacterial Agents)

Date Created: 20181114 Date Completed: 20190321 Latest Revision: 20190321

20221213

PMC6254481

30421882