Pilot study for appropriate anti-infective community therapy. Effect of a guideline-based strategy to optimize use of antibiotics.

Abstract

OBJECTIVE:

To determine whether a community-wide, multi-intervention educational strategy (CoMPLI model) could enhance adoption of clinical guidelines and improve the use of antibiotics.

DESIGN:

Before-after trial using baseline and study periods with a control group.

SETTING:

A small community in central Ontario.

PARTICIPANTS:

Health professionals, the general public, and the pharmaceutical industry.

INTERVENTIONS:

The educational strategy (CoMPLI), carried out during 6 winter months, consisted of continuing medical education sessions for health professionals and pharmaceutical representatives and a parallel public education campaign that included town hall meetings and pamphlets distributed by local pharmacists. The two main messages were: do not use antibiotics for viral respiratory infections, and use drugs recommended in the publication, Anti-infective Guidelines for Community-Acquired Infections.

MAIN OUTCOME MEASURES:

Total number of antibiotic claims and adjusted odds ratios (OR) were used to measure the likelihood of physicians prescribing first- or second-line agents compared with the previous year and compared with control physicians.

RESULTS:

Claims in the study community decreased by nearly 10% during the 6-month study period compared with the baseline period from the previous year. Study physicians were 29% less likely (OR-1 = 0.71, range 0.67 to 0.76) to prescribe second-line antibiotics during the study period than physicians in the rest of the province.

CONCLUSIONS:

Physicians participating in the pilot study were more likely to follow drug recommendations outlined in published guidelines.

• Authors: J Stewart, J Pilla, L Dunn
• Journal: Canadian family physician Medecin de famille canadien (Can Fam Physician) Vol. 46 Pg. 851-9 (Apr 2000) ISSN: 0008-350X [Print] Canada
• PMID: 10790817 (Publication Type: Comparative Study, Journal Article, Research Support, Non-U.S. Gov't)

Chemical References

• Anti-Bacterial Agents

Topics

• Adult
• Anti-Bacterial Agents (administration & dosage, therapeutic use)
• Community-Acquired Infections (drug therapy)
• Data Interpretation, Statistical
• Drug Prescriptions
• Humans
• Odds Ratio
• Ontario
• Pilot Projects
• Practice Guidelines as Topic
• Respiratory Tract Infections (drug therapy)
• Virus Diseases (drug therapy)