De la vigilancia a la acción: modificando conductas terapéuticas en la infección gonocócica

OBJECTIVES: To evaluate improvements in the prescriptions for gonococcal infection after developing a specific public health intervention. Furthermore, to ascertain the proportion of cases diagnosed by culture and current antimicrobial resistance. LOCATION: Galicia, Spain. DESIGN: Before-after study of adherence to the recommended treatment for gonococcal infection (ceftriaxone + azithromycin) after a Public Health intervention. PARTICIPANTS: All Primary Care physicians who had identified and treated a case of gonococcal infection. STUDY PERIOD: Preintervention (2012-13) and postintervention (2014-17). INTERVENTIONS: Access to the recommended treatment (ceftriaxone and azithromycin) was provided in Primary Care and all the information was disseminated to Primary Care physicians and microbiologists through the publication Venres Epidemiolóxico. MAIN MEASUREMENTS: The study variables were year, prescribed treatment, performing of culture, antibiotic susceptibility testing. The percentages for each of them were calculated. RESULTS: The recommended treatment was used in 3% in 2012-2013, and after the interventions it increased to a mean of 58%. The frequency of culture remained relatively constant after the interventions. Sensitivity to other antibiotics improved as their use decreased. CONCLUSIONS: The interventions carried out implied an improvement in the adherence to the recommended treatment for gonococcal infection in Galicia.