Education cuts antibiotic use
MedWire News: An educational programme can successfully cut down antibiotic dispensing in primary care, research published in the BMJ shows.
General practices that underwent the Stemming the Tide of Antibiotic Resistance (STAR) programme dispensed 14 fewer oral antibiotics per 1000 registered patients over the following year.
This compared with an increase of 12 oral antibiotics per 1000 patients during the same period at practices that did not receive the educational intervention.
The STAR educational programme involves a mixture of learning methods, including a practice based seminar reflecting on the practices' own dispensing and resistance data, provision of latest research evidence and guidelines, online learning tools and practice at routine consulting skills. The programme can be viewed at the STAR website (click here).
The study, by Dr Christopher Butler (Professor of Primary Care Medicine, Cardiff University) and colleagues, included 68 general practices in Wales with around 480,000 patients. Half the practices were randomized to the intervention, the other 34 to be controls.
Dr Butler and colleagues note that the net 26-item reduction per 1000 patients per year resulting from the STAR intervention represents a 4.2% drop in total oral antibiotic dispensing for all ages and conditions. Of note, the biggest reductions were seen for phenoxymethylpenicillins (penicillin V) and macrolides.
The researchers found no evidence that antibiotic use was lowered at the expense of increased reconsultations or complications with common infections. And they say the cost of the intervention (around £3000 per practice) would likely be recouped within 3.5 years.
Canadian editorialists Professor James McCormack (University of British Columbia, Vancouver) and Professor Michael Allen (University of Alberta, Edmonton) question whether a 4.2% cut in antibiotic use would have a meaningful impact on resistance, however.
MedWire News is an independent clinical news service provided by Springer Healthcare Limited. © Springer Healthcare Ltd; 2012
By Caroline Price