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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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Formato: | Online Artículo Texto |
Lenguaje: | English |
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BMJ Publishing Group
2018
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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 |
collection | PubMed |
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. |
format | Online Article Text |
id | pubmed-6267302 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2018 |
publisher | BMJ Publishing Group |
record_format | MEDLINE/PubMed |
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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