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Effect of intervention promoting a reduction in antibiotic prescribing by improvement of diagnostic procedures: a prospective, before and after study in general practice

  • Pharmacogenetics
  • Published:
European Journal of Clinical Pharmacology Aims and scope Submit manuscript

Abstract

Objective

To investigate if an intervention aimed at improving the quality of the diagnostic procedures in Spanish general practice could lower antibiotic prescribing in patients with respiratory tract infections (RTIs).

Methods

GPs in the intervention group (n=17) registered all patients with RTIs during a 3-week period before and after the intervention. The intervention was aimed at reducing prescribing of inappropriate antibiotics for RTIs by improving the diagnostic procedures and thereby helping the GPs to distinguish between bacterial and viral infections. It consisted of courses in management of RTI according to local clinical guidelines, and included implementation of two rapid diagnostic tests (StrepA and CRP measurement). Diagnoses and prescribing of antibiotics were assessed before and after the intervention, and compared to a control group not exposed to intervention (35 GPs).

Results

The intervention led to a significant reduction in antibiotic prescribing. Before the intervention 36% (29%–44%) of consultations were followed by antibiotic prescribing, after the intervention 24% (20%–29%). Antibiotic prescribing in the control group not exposed to intervention was 32% (27%–38%). The reduction was most pronounced in patients with sinusitis and lower RTIs.

Conclusion

Quality improvement of diagnostic procedures may lead to a reduction of antibiotic prescribing in primary health care in Spain.

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Acknowledgement

The authors wish to thank the general practitioners in Spain for their participation in the study.

Author information

Authors and Affiliations

  1. Research Unit for General Practice, University of Southern Denmark, J. B. Winsløws Vej 9 A, DK-5000, Odense C, Denmark

    Lars Bjerrum

  2. Catalan Society of Family Medicine, Barcelona, Spain

    Josep M. Cots, Carl Llor & Núria Molist

  3. Audit Project Odense, Research Unit for General Practice, University of Southern Denmark, Odense C, Denmark

    Anders Munck

Authors
  1. Lars Bjerrum
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  2. Josep M. Cots
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  3. Carl Llor
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  4. Núria Molist
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  5. Anders Munck
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Corresponding author

Correspondence to Lars Bjerrum.

Additional information

Contributors: LB participated in the intervention, performed the analysis and wrote the manuscript. JMC participated in intervention, collected data, and revised the paper. CL participated in intervention, collected data and revised the paper. NM participated in intervention, collected data and revised the paper, AM conceived the method and extensively revised the paper.

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Bjerrum, L., Cots, J.M., Llor, C. et al. Effect of intervention promoting a reduction in antibiotic prescribing by improvement of diagnostic procedures: a prospective, before and after study in general practice. Eur J Clin Pharmacol 62, 913–918 (2006). https://doi.org/10.1007/s00228-006-0187-y

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  • DOI: https://doi.org/10.1007/s00228-006-0187-y

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