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Reducing inappropriate antibiotic prescribing in upper respiratory tract infection in a primary care setting in Kolkata, India

Inappropriate antibiotic use is a key factor in the emergence of antibiotic resistance. The majority of antibiotics are prescribed in primary care, where upper respiratory tract infection (URTI) is a common presentation. Inappropriate antibiotic prescribing in URTI is common globally and has increas...

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Autor principal: Dehn Lunn, Amy
Formato: Online Artículo Texto
Lenguaje:English
Publicado: BMJ Publishing Group 2018
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6267302/
https://www.ncbi.nlm.nih.gov/pubmed/30555928
http://dx.doi.org/10.1136/bmjoq-2017-000217
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author Dehn Lunn, Amy
author_facet Dehn Lunn, Amy
author_sort Dehn Lunn, Amy
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description Inappropriate antibiotic use is a key factor in the emergence of antibiotic resistance. The majority of antibiotics are prescribed in primary care, where upper respiratory tract infection (URTI) is a common presentation. Inappropriate antibiotic prescribing in URTI is common globally and has increased markedly in developing and transitional countries. Antibiotic stewardship is crucial to prevent the emergence and spread of resistant microbes. This project aimed to reduce inappropriate antibiotic prescribing in URTI in a non-governmental organisation’s primary care outreach clinics in Kolkata, India, from 62.6% to 30% over 4 months. A multifaceted intervention to reduce inappropriate antibiotic use in non-specific URTI was implemented. This consisted of a repeated process of audit and feedback, interactive training sessions, one-to-one case-based discussion, antibiotic guideline development and coding updates. The primary outcome measure was antibiotic prescribing rates. A baseline audit of all patients presenting with non-specific URTI over 8 weeks in November and December 2016 (n=222) found that 62.6% were prescribed antibiotics. Postintervention audit over 4 weeks in April 2017 (n=69) showed a marked reduction in antibiotic prescribing to 7.2%. An increase in documentation of examination findings was also observed, from 52.7% to 95.6%. This multifaceted intervention was successful at reducing inappropriate antibiotic prescribing, with sustained reductions demonstrated over the 4 months of the project. This suggests that approaches previously used in Europe can successfully be applied to different settings.
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spelling pubmed-62673022018-12-16 Reducing inappropriate antibiotic prescribing in upper respiratory tract infection in a primary care setting in Kolkata, India Dehn Lunn, Amy BMJ Open Qual BMJ Quality Improvement report Inappropriate antibiotic use is a key factor in the emergence of antibiotic resistance. The majority of antibiotics are prescribed in primary care, where upper respiratory tract infection (URTI) is a common presentation. Inappropriate antibiotic prescribing in URTI is common globally and has increased markedly in developing and transitional countries. Antibiotic stewardship is crucial to prevent the emergence and spread of resistant microbes. This project aimed to reduce inappropriate antibiotic prescribing in URTI in a non-governmental organisation’s primary care outreach clinics in Kolkata, India, from 62.6% to 30% over 4 months. A multifaceted intervention to reduce inappropriate antibiotic use in non-specific URTI was implemented. This consisted of a repeated process of audit and feedback, interactive training sessions, one-to-one case-based discussion, antibiotic guideline development and coding updates. The primary outcome measure was antibiotic prescribing rates. A baseline audit of all patients presenting with non-specific URTI over 8 weeks in November and December 2016 (n=222) found that 62.6% were prescribed antibiotics. Postintervention audit over 4 weeks in April 2017 (n=69) showed a marked reduction in antibiotic prescribing to 7.2%. An increase in documentation of examination findings was also observed, from 52.7% to 95.6%. This multifaceted intervention was successful at reducing inappropriate antibiotic prescribing, with sustained reductions demonstrated over the 4 months of the project. This suggests that approaches previously used in Europe can successfully be applied to different settings. BMJ Publishing Group 2018-11-20 /pmc/articles/PMC6267302/ /pubmed/30555928 http://dx.doi.org/10.1136/bmjoq-2017-000217 Text en © Author(s) (or their employer(s)) 2018. Re-use permitted under CC BY-NC. No commercial re-use. See rights and permissions. Published by BMJ. This is an open access article distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited, appropriate credit is given, any changes made indicated, and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/.
spellingShingle BMJ Quality Improvement report
Dehn Lunn, Amy
Reducing inappropriate antibiotic prescribing in upper respiratory tract infection in a primary care setting in Kolkata, India
title Reducing inappropriate antibiotic prescribing in upper respiratory tract infection in a primary care setting in Kolkata, India
title_full Reducing inappropriate antibiotic prescribing in upper respiratory tract infection in a primary care setting in Kolkata, India
title_fullStr Reducing inappropriate antibiotic prescribing in upper respiratory tract infection in a primary care setting in Kolkata, India
title_full_unstemmed Reducing inappropriate antibiotic prescribing in upper respiratory tract infection in a primary care setting in Kolkata, India
title_short Reducing inappropriate antibiotic prescribing in upper respiratory tract infection in a primary care setting in Kolkata, India
title_sort reducing inappropriate antibiotic prescribing in upper respiratory tract infection in a primary care setting in kolkata, india
topic BMJ Quality Improvement report
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6267302/
https://www.ncbi.nlm.nih.gov/pubmed/30555928
http://dx.doi.org/10.1136/bmjoq-2017-000217
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