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Feasibility of a primary care intervention to decrease oral antibiotics for acute upper respiratory tract infections:
Meera Kelley1, Mark W Massing, Joshua Young
1Quality and Patient Safety, WakeMed Health and Hospitals, USA. mkelley@wakemed.org
Background:
Antimicrobial resistance in common respiratory tract pathogens is a growing public health threat, especially in the southeastern United States. The excessive use of antibiotics for common infections is a major contributing factor in the emergence of antibiotic resistance. We report results from a multi-site outpatient pilot project in North Carolina to reduce antibiotic prescriptions for acute nonbacterial upper respiratory tract infections (URIs).
Methods:
Primary care practices were provided education and symptom therapy kits for patients with URIs, as an alternative to antibiotics, in a project to reduce the overuse of antimicrobial therapy The feasibility of this approach was evaluated with interviews and surveys. A methodology for claims-based evaluation of intervention efficacy in reduction of antibiotics use was developed as part of this project.
Results:
Of eight contacted practices, four agreed to participate and three participated fully. Physicians reported that symptom therapy kits were useful for patients with URIs and resulted in a meaningful change in antibiotic prescribing behaviors. A claims-based approach is a feasible and promising method to evaluate efficacy in subsequent post-pilot large-scale implementations.
Limitations:
Due to the small number of outpatient practices and the lack of controls in this pilot study, the efficacy of the intervention in reducing antibiotic use could not be determined.
Conclusions:
Education combined with symptom therapy kits as an alternative to oral antibiotics is a feasible intervention that warrants additional studies to evaluate the efficacy of this approach in the reduction of antibiotic use for URIs.
Insights
This pilot study explored reducing antibiotic prescriptions for upper respiratory tract infections (URIs) using education and symptom kits. While not definitively proven, the intervention showed promise for future large-scale implementation.
Area of Science:
- Public Health
- Infectious Diseases
- Primary Care Medicine
Background:
- Antimicrobial resistance is a significant public health concern, particularly in respiratory pathogens.
- Overuse of antibiotics for common infections accelerates the development of antibiotic resistance.
- The southeastern United States faces a growing threat from antibiotic-resistant bacteria.
Purpose of the Study:
- To pilot an intervention aimed at reducing antibiotic prescriptions for acute nonbacterial upper respiratory tract infections (URIs).
- To evaluate the feasibility of using education and symptom therapy kits as an alternative to antibiotics.
- To develop a methodology for assessing intervention efficacy through claims data.
Main Methods:
- Four primary care practices in North Carolina participated in the pilot project.
- Practices received educational materials and patient symptom therapy kits.
- Feasibility was assessed via physician interviews and patient surveys; claims data methodology was developed.
Main Results:
- Physicians found symptom therapy kits beneficial for URI patients.
- The intervention appeared to meaningfully alter antibiotic prescribing habits.
- A claims-based evaluation method proved feasible for future studies.
Conclusions:
- The intervention, combining education with symptom kits, is a feasible approach for reducing antibiotic use in URIs.
- Further research with larger sample sizes and controls is needed to confirm efficacy.
- This strategy warrants additional study for widespread implementation.
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