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Changes in antimicrobial prescribing patterns following a healthcare provider educational intevention

Nadia Shalauta Juzych, ScD, MS1, Mousumi Banerjee, PhD2, Lynnette Essenmacher2, and Stephen Lerner, MD3. (1) Maternal and Adolescent Health, Michigan Public Health Institute, 352 Baldwin, Birmingham, MI 48009, 248 342.4603, njuzych@wayne.edu, (2) Center for Healthcare Effectiveness Reseach, Wayne State University School of Medicine, 4325 Brush, Suite 121, Schiffman Medical Library, Detroit, MI 48201, (3) Division of Infectious Disease, Wayne State University School of Medicine, 4990 John R Road, Harper Hospital, Detroit, MI 48201

Inappropriate use of antimicrobials in the treatment of acute upper respiratory tract infections, which usually have a viral etiology, contributes to the emergence and spread of antimicrobial resistance in Streptococcus pneumoniae and other human pathogens. This study utilized an interactive case-based educational program on appropriate use of antimicrobials in the treatment of upper respiratory tract infections in an effort to address the growing problem of inappropriate antimicrobial use. The study included 21 primary care physicians at two clinics where the educational intervention was implemented, and nine primary care physicians at two control clinics. Pediatric and adult medicine physicians and their staff were included in the program which was conducted at an inner city health maintenance organization (HMO) clinic for indigent patients. The study was conducted as a prospective, non-randomized control trial, and evaluated antibiotic prescribing for acute upper respiratory tract infections during the baseline and study years among the intervention and control groups. Findings showed that antimicrobial prescribing among the physicians who received the educational intervention decreased 24.6% between the baseline and study years (p<0.0001) for both pediatric and adult medicine physicians. There was no significant decline in rates of antimicrobial prescribing for the control group of physicians between the baseline and study years for pediatric (p=0.35) or adult medicine (p=0.42) physicians. There was a significant difference in the decline in rates of antimicrobial prescribing between the control and intervention groups (p<0.0003 for pediatricians and p<0.01 for adult medicine physicians).

Learning Objectives:

Keywords: Antibiotic Resistance, Providers

Presenting author's disclosure statement:
I do not have any significant financial interest/arrangement or affiliation with any organization/institution whose products or services are being discussed in this session.

Infectious Disease Epidemiology: Poster Session

The 132nd Annual Meeting (November 6-10, 2004) of APHA