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Educational intervention reduces antibiotic prescribing for childhood URTIs 1 year later
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An educational intervention program for Chinese primary care doctors was effective in reducing antibiotic prescriptions for childhood upper respiratory tract infections a year after the intervention had ended, according to study results published in the PLoS Medicine.
“We conducted a follow-up study to investigate sustainability of an antimicrobial stewardship program 12 months after a cluster randomized trial ceased. In one of the two counties, we observed a 36-percentage point reduction of prescription rates for children’s upper respiratory tract infections (URTIs) between the intervention and control arms,” Qiang Sun, MD, PhD, a professor and executive dean of the School of Health Care Management at Shandong University in Jinan, Shandong, China, told Infectious Diseases in Children.
Sun and colleagues conducted the randomized controlled trial in two rural counties in China to measure an intervention that included clinical guidelines, monthly prescribing review meetings, doctor-patient communication skills training and education materials. At 6-month follow-up, they reported that the intervention had reduced antibiotic prescribing for childhood URTIs by 29 percentage points.
In the follow-up study, the researchers focused on one of the two counties in the original study that had electronic records available 12 months after the study ended. The county included 14 health care facilities. The primary outcome of the follow-up study was the antibiotic prescription rate (APR), or the percentage of outpatient prescriptions containing any antibiotics for children aged 2 to 14 years who had a primary diagnosis of a URTI and had no other illness requiring antibiotics.
The researchers reported that the APR in intervention facilities was 84% at baseline, 37% at 6 months and 54% at 18 months. In control facilities, the APR was 76% at baseline, 77% at 6 months and 75% at 18 months. After adjusting for patient and prescribing doctor covariates, the difference at 6 months between the facilities represented an APR of –49 percentage points attributable to the interventions and an APR of –36 percentage points at 18 months.
“Evidence from our trial and this long-term follow-up study shows that our intervention appears to have changed doctors’ knowledge and attitudes and led to long-term benefits in antibiotic prescribing,” the researchers concluded. – by Bruce Thiel
Disclosures: The authors report no relevant financial disclosures.
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