Skip Navigation


JAC Advance Access originally published online on July 28, 2004
This Article
Right arrow Full Text Freely available
Right arrow FREE Full Text (PDF) Freely available
Right arrow All Versions of this Article:
54/3/661    most recent
dkh374v1
Right arrow Alert me when this article is cited
Right arrow Alert me if a correction is posted
Services
Right arrow Email this article to a friend
Right arrow Similar articles in this journal
Right arrow Similar articles in ISI Web of Science
Right arrow Similar articles in PubMed
Right arrow Alert me to new issues of the journal
Right arrow Add to My Personal Archive
Right arrow Download to citation manager
Right arrow Search for citing articles in:
ISI Web of Science (19)
Right arrowRequest Permissions
Right arrow Disclaimer
Google Scholar
Right arrow Articles by Coenen, S.
Right arrow Articles by Denekens, J.
Right arrow Search for Related Content
PubMed
Right arrow PubMed Citation
Right arrow Articles by Coenen, S.
Right arrow Articles by Denekens, J.
Social Bookmarking
Add to CiteULike   Add to Connotea   Add to Del.icio.us  
What's this?

Journal of Antimicrobial Chemotherapy 2004 54(3):661-672; doi:10.1093/jac/dkh374
JAC vol.54 no.3 © The British Society for Antimicrobial Chemotherapy 2004; all rights reserved.

Optimizing antibiotic prescribing for acute cough in general practice: a cluster-randomized controlled trial

Samuel Coenen*, Paul Van Royen, Barbara Michiels and Joke Denekens

Centre for General Practice, University of Antwerp, BE 2610 Antwerp, Belgium

* Corresponding author. Tel: +32-3-8202525; Fax: +32-3-8202526; Email: samuel.coenen{at}ua.ac.be

Objectives: To assess the effect of a tailored professional intervention, including academic detailing, on antibiotic prescribing for acute cough.

Methods: In a cluster-randomized controlled before and after study 85 Flemish GPs included adult patients with acute cough consulting in the periods February–April 2000 and 2001. The intervention consisted of a clinical practice guideline for acute cough, an educational outreach visit and a postal reminder to support its implementation in January 2001. Antibiotic prescribing rates and patients' symptom resolution were the main outcome measures.

Results: Thirty-six of 42 GPs received the intervention and 35 of 43 GPs served as controls; 1503 patients were eligible for analysis. Only in the intervention group were patients less likely to receive antibiotics after the intervention [ORadj (95% CI)=0.56 (0.36–0.87)]. Prescribed antibiotics were also more in line with the guideline in the intervention group [1.90 (0.96–3.75)] and less expensive from the perspective of the National Sickness and Invalidity Insurance Institute {MDadj (95% CI)=–{euro}6.89 [–11.77–(–2.02)]}. No significant differences were found between the groups for the time to symptom resolution.

Conclusions: An (inter)actively delivered tailored intervention implementing a guideline for acute cough is successful in optimizing antibiotic prescribing without affecting patients' symptom resolution. Further research efforts should be devoted to cost-effectiveness studies of such interventions.

Keywords: primary care , respiratory tract infections , guidelines , antibacterials , academic detailing


Add to CiteULike CiteULike   Add to Connotea Connotea   Add to Del.icio.us Del.icio.us    What's this?


This article has been cited by other articles:


Home page
 BMJHome page
C C Butler, K Hood, T Verheij, P Little, H Melbye, J Nuttall, M J Kelly, S Molstad, M Godycki-Cwirko, J Almirall, et al.
Variation in antibiotic prescribing and its impact on recovery in patients with acute cough in primary care: prospective study in 13 countries
BMJ, June 23, 2009; 338(jun23_2): b2242 - b2242.
[Abstract] [Full Text] [PDF]

Home page
 BMJHome page
J. W L Cals, C. C Butler, R. M Hopstaken, K. Hood, and G.-J. Dinant
Effect of point of care testing for C reactive protein and training in communication skills on antibiotic use in lower respiratory tract infections: cluster randomised trial
BMJ, May 5, 2009; 338(may05_1): b1374 - b1374.
[Abstract] [Full Text] [PDF]

Home page
 J Antimicrob ChemotherHome page
A. Altiner, S. Brockmann, M. Sielk, S. Wilm, K. Wegscheider, and H.-H. Abholz
Reducing antibiotic prescriptions for acute cough by motivating GPs to change their attitudes to communication and empowering patients: a cluster-randomized intervention study
J. Antimicrob. Chemother., September 1, 2007; 60(3): 638 - 644.
[Abstract] [Full Text] [PDF]

Home page
 Qual Saf Health CareHome page
M L van Driel, S Coenen, K Dirven, J Lobbestael, I Janssens, P Van Royen, F M Haaijer-Ruskamp, M De Meyere, J De Maeseneer, and T Christiaens
What is the role of quality circles in strategies to optimise antibiotic prescribing? A pragmatic cluster-randomised controlled trial in primary care
Qual. Saf. Health Care, June 1, 2007; 16(3): 197 - 202.
[Abstract] [Full Text] [PDF]

Home page
 DTBHome page
Avoiding antibacterial overuse in primary care
DTB, April 1, 2007; 45(4): 25 - 29.
[Abstract] [Full Text] [PDF]

Home page
 J Antimicrob ChemotherHome page
Y. Razon, S. Ashkenazi, A. Cohen, E. Hering, S. Amzel, H. Babilsky, A. Bahir, E. Gazala, and I. Levy
Effect of educational intervention on antibiotic prescription practices for upper respiratory infections in children: a multicentre study
J. Antimicrob. Chemother., November 1, 2005; 56(5): 937 - 940.
[Abstract] [Full Text] [PDF]


Disclaimer: Please note that abstracts for content published before 1996 were created through digital scanning and may therefore not exactly replicate the text of the original print issues. All efforts have been made to ensure accuracy, but the Publisher will not be held responsible for any remaining inaccuracies. If you require any further clarification, please contact our Customer Services Department.