Optimizing antibiotic prescribing for acute cough in general practice: a cluster-randomized controlled trial

Area of Science:

• General Practice
• Infectious Disease Management
• Health Services Research

Background:

• Antibiotic overuse for acute cough contributes to antimicrobial resistance.
• Optimizing antibiotic prescribing in primary care is a public health priority.

Purpose of the Study:

• To evaluate the effectiveness of a tailored professional intervention on antibiotic prescribing for acute cough among general practitioners (GPs).

Main Methods:

• A cluster-randomized controlled before-and-after study involving 85 Flemish GPs.
• Intervention included a clinical practice guideline, educational outreach, and postal reminders.
• Primary outcomes were antibiotic prescribing rates and patient symptom resolution.

Main Results:

• The intervention group showed significantly lower antibiotic prescribing rates compared to controls [OR(adj)=0.56].
• Antibiotic use in the intervention group was more guideline-adherent and cost-effective.
• No significant difference in time to symptom resolution between groups.

Conclusions:

• A tailored, guideline-based intervention effectively optimizes antibiotic prescribing for acute cough in primary care.
• The intervention improved prescribing patterns without negatively affecting patient outcomes.
• Further research into the cost-effectiveness of such interventions is warranted.