OBJECTIVE: To decrease unnecessary antibiotic use for acute respiratory tract infections in adults in a point-of-service health care setting. DESIGN: Prospective, nonrandomized controlled trial. SETTING: An urban urgent care clinic associated with the major indigent care hospital in Denver, Colorado between October 2000 and April 2001. PATIENTS/PARTICIPANTS: Adults diagnosed with acute respiratory tract infections (bronchitis, sinusitis, pharyngitis, and nonspecific upper respiratory infection). A total of 554 adults were included in the baseline period (October to December 2000) and 964 adults were included in the study period (January to April 2001). INTERVENTIONS: A provider educational session on recommendations for appropriate antibiotic use recently published by the Centers for Disease Control and Prevention, and placement of examination room posters were performed during the last week of December 2000. Study period patients who completed a brief, interactive computerized education (ICE) module were classified as being exposed to the full intervention, whereas study period patients who did not complete the ICE module were classified as being exposed to the limited intervention. MEASUREMENTS AND MAIN RESULTS: The proportion of patients diagnosed with acute bronchitis who received antibiotics decreased from 58% during the baseline period to 30% and 24% among patients exposed to the limited and full intervention, respectively (P <.001 for intervention groups vs baseline). Antibiotic prescriptions for nonspecific upper respiratory tract infections decreased from 14% to 3% and 1% in the limited- and full-intervention groups, respectively (P <.001 for intervention groups vs baseline). CONCLUSION: Antibiotic use for adults diagnosed with acute respiratory tract infections can be reduced in a point-of-service health care setting using a combination of patient and provider educational interventions.
OBJECTIVE: To decrease unnecessary antibiotic use for acute respiratory tract infections in adults in a point-of-service health care setting. DESIGN: Prospective, nonrandomized controlled trial. SETTING: An urban urgent care clinic associated with the major indigent care hospital in Denver, Colorado between October 2000 and April 2001. PATIENTS/PARTICIPANTS: Adults diagnosed with acute respiratory tract infections (bronchitis, sinusitis, pharyngitis, and nonspecific upper respiratory infection). A total of 554 adults were included in the baseline period (October to December 2000) and 964 adults were included in the study period (January to April 2001). INTERVENTIONS: A provider educational session on recommendations for appropriate antibiotic use recently published by the Centers for Disease Control and Prevention, and placement of examination room posters were performed during the last week of December 2000. Study period patients who completed a brief, interactive computerized education (ICE) module were classified as being exposed to the full intervention, whereas study period patients who did not complete the ICE module were classified as being exposed to the limited intervention. MEASUREMENTS AND MAIN RESULTS: The proportion of patients diagnosed with acute bronchitis who received antibiotics decreased from 58% during the baseline period to 30% and 24% among patients exposed to the limited and full intervention, respectively (P <.001 for intervention groups vs baseline). Antibiotic prescriptions for nonspecific upper respiratory tract infections decreased from 14% to 3% and 1% in the limited- and full-intervention groups, respectively (P <.001 for intervention groups vs baseline). CONCLUSION: Antibiotic use for adults diagnosed with acute respiratory tract infections can be reduced in a point-of-service health care setting using a combination of patient and provider educational interventions.
Authors: J A Finkelstein; R L Davis; S F Dowell; J P Metlay; S B Soumerai; S L Rifas-Shiman; M Higham; Z Miller; I Miroshnik; A Pedan; R Platt Journal: Pediatrics Date: 2001-07 Impact factor: 7.124
Authors: R Gonzales; J G Bartlett; R E Besser; R J Cooper; J M Hickner; J R Hoffman; M A Sande Journal: Ann Intern Med Date: 2001-03-20 Impact factor: 25.391
Authors: R J Cooper; J R Hoffman; J G Bartlett; R E Besser; R Gonzales; J M Hickner; M A Sande Journal: Ann Intern Med Date: 2001-03-20 Impact factor: 25.391
Authors: Alike W van der Velden; Eefje J Pijpers; Marijke M Kuyvenhoven; Sarah K G Tonkin-Crine; Paul Little; Theo J M Verheij Journal: Br J Gen Pract Date: 2012-12 Impact factor: 5.386
Authors: Rakesh D Mistry; Jason G Newland; Jeffrey S Gerber; Adam L Hersh; Larissa May; Sarah M Perman; Nathan Kuppermann; Peter S Dayan Journal: Infect Control Hosp Epidemiol Date: 2017-02-08 Impact factor: 3.254
Authors: Ralph Gonzales; Tammy Anderer; Charles E McCulloch; Judith H Maselli; Frederick J Bloom; Thomas R Graf; Melissa Stahl; Michelle Yefko; Julie Molecavage; Joshua P Metlay Journal: JAMA Intern Med Date: 2013-02-25 Impact factor: 21.873
Authors: Elaine Larson; Yu-Hui Ferng; Jennifer Wong; Maria Alvarez-Cid; Angela Barrett; Maria J Gonzalez; Shuang Wang; Stephen S Morse Journal: J Immigr Minor Health Date: 2008-05-28
Authors: Mary Catherine Beach; Tiffany L Gary; Eboni G Price; Karen Robinson; Aysegul Gozu; Ana Palacio; Carole Smarth; Mollie Jenckes; Carolyn Feuerstein; Eric B Bass; Neil R Powe; Lisa A Cooper Journal: BMC Public Health Date: 2006-04-24 Impact factor: 3.295