JAC Advance Access originally published online on September 27, 2005
Journal of Antimicrobial Chemotherapy 2005 56(5):937-940; doi:10.1093/jac/dki339
| ||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||
Effect of educational intervention on antibiotic prescription practices for upper respiratory infections in children: a multicentre study
1 Pediatric Infectious Disease Unit, Schneider Children's Medical Center of Israel, Petah Tiqva 49202, Israel; 2 Community Child Health Centers for the Study of Antibiotic Usage, Clalit Health Organization, Tel-Aviv, Israel; both the Pediatric Infectious Disease Unit and the Community Child Health Centers for the Study of Antibiotic Usage are affiliated with the Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel
Received 2 May 2005; returned 20 June 2005; revised 26 July 2005; accepted 25 August 2005
* Corresponding author. Tel: +972-3-925-3662; Fax: +972-3-925-3129; E-mail: yaronraz{at}clalit.org.il
Objectives: To evaluate the impact of an educational intervention on judicious antibiotic prescription for upper respiratory diseases in children.
Methods: A multicentre before-and-after study was conducted in five major community child healthcentres in Israel. Antibiotic prescription data were collected for all visits of patients aged 3 months to 18 years with a diagnosis of acute otitis media, tonsillopharyngitis, sinusitis or upper respiratory tract infection from November 1999 through February 2000 (pre-intervention period) and from November 2000 through February 2001 (post-intervention period). The intervention consisted of a 1 day seminar on the diagnosis and judicious treatment of respiratory tract infections in children according to the recommendations of the Centers of Disease Control and Prevention. The patient files were reviewed for patient characteristics, specific respiratory disease, and specific antibiotics prescribed. The main outcome measures were the rates and appropriateness of antibiotic prescribing for the different respiratory diseases before and after an educational intervention for practising paediatricians.
Results: A total of 4580 clinic visits were eligible for analysis in the pre-intervention period and 4364 in the post-intervention period. From the pre- to the post-intervention period, the odds ratio for appropriate antibiotic treatment was 1.8 for acute otitis media (95% CI 1.52–2.11, P < 0.01) and 1.35 for pharyngitis (95% CI 1.13–1.61, P < 0.01). Overall, use of antibiotics for acute otitis media decreased from 93% to 87.4% (P < 0.05), and for upper respiratory tract infection, from 13.8% to 11.5% (P < 0.05). There were no significant changes in these factors for sinusitis.
Conclusions: A targeted educational intervention can improve antibiotic prescription practices for respiratory infections in children and decrease unnecessary antibiotic use. Such studies can also pinpoint areas that require further attention.
Keywords: antibiotics , respiratory tract infections , education , treatment , community
CiteULike 
Connotea 
Del.icio.us What's this?
This article has been cited by other articles:
|
|
 |
|
  Avoiding antibacterial overuse in primary care DTB, April 1, 2007; 45(4): 25 - 29. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 S. A. Simpson, F. Wood, and C. C. Butler General practitioners' perceptions of antimicrobial resistance: a qualitative study J. Antimicrob. Chemother., February 1, 2007; 59(2): 292 - 296. [Abstract] [Full Text] [PDF]
|
|