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VNA of Care New England

Education, Audit, Feedback Improve Antibiotic Rx

Findings based on pediatricians prescribing behaviors for bacterial respiratory infections
TUESDAY, June 11 (HealthDay News) -- Clinician education coupled with audit and feedback can improve adherence of antibiotic prescribing guidelines for common bacterial acute respiratory tract infections (ARTIs), according to a study published in the June 12 issue of the Journal of the American Medical Association.
Jeffrey S. Gerber, M.D., Ph.D., from the Children's Hospital of Philadelphia, and colleagues evaluated an antimicrobial stewardship intervention (one-hour on-site clinician education session) on prescribing patterns of broad-spectrum antibiotics among 162 providers at 18 pediatric outpatient practices for one year after the intervention.
The researchers found that broad-spectrum antibiotic prescribing decreased from 26.8 to 14.3 percent among intervention practices versus from 28.4 to 22.6 percent in controls (difference of differences [DOD], 6.7 percent). For children with pneumonia, off-guideline prescribing decreased from 15.7 to 4.2 percent among intervention practices and from 17.1 to 16.3 percent in controls (DOD, 10.7 percent). For acute sinusitis, the declines were 38.9 to 18.8 percent in intervention practices and 40.0 to 33.9 percent in controls (DOD, 14.0 percent). For streptococcal pharyngitis, off-guideline prescribing was uncommon at baseline and changed little (intervention, 4.4 to 3.4 percent; control, 5.6 to 3.5 percent; DOD, −1.1 percent). For viral infections there was also little change (intervention, 7.9 to 7.7 percent; control, 6.4 to 4.5 percent; DOD, −1.7 percent).
"In this large pediatric primary care network, clinician education coupled with audit and feedback, compared with usual practice, improved adherence to prescribing guidelines for common bacterial ARTIs, and the intervention did not affect antibiotic prescribing for viral infections," the authors write.
One author disclosed financial ties to the pharmaceutical industry.
Abstract (http://jama.jamanetwork.com/article.aspx?articleid=1696098#Abstract )Full Text (http://jama.jamanetwork.com/article.aspx?articleid=1696098 )Editorial (subscription or payment may be required) (http://jama.jamanetwork.com/article.aspx?articleid=1696084 )
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