JAC Advance Access published online on July 28, 2004
Journal of Antimicrobial Chemotherapy, doi:10.1093/jac/dkh374
© 2004 by The British Society for Antimicrobial Chemotherapy
| ||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||
1 Centre for General Practice, University of Antwerp, BE 2610 Antwerp, Belgium
* To whom correspondence should be addressed. E-mail: 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)=- 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.
Revised May 3, 2004
Accepted June 25, 2004
Original article
Optimizing antibiotic prescribing for acute cough in general practice: a cluster-randomized controlled trial
Abstract 
6.89 [-11.77-(-2.02)]}. No significant differences were found between the groups for the time to symptom resolution.
CiteULike 
Connotea 
Del.icio.us What's this?
This article has been cited by other articles:
|
|
 |
|
  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]
|
|
|
|
|
|
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]
|
|
|
|
 |
|
 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]
|
|
|
|
 |
|
 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]
|
|
|
|
 |
|
 Avoiding antibacterial overuse in primary care DTB, April 1, 2007; 45(4): 25 - 29. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
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]
|
|