Improving antimicrobial prescribing practice for sore throat symptoms in a general practice setting

Area of Science:

• Primary Care Medicine
• Infectious Disease Management
• Health Informatics

Background:

• Acute sore throat is a frequent primary care complaint.
• Antibiotic overuse for sore throats contributes to antimicrobial resistance.
• National guidelines (Centor criteria) exist to optimize antibiotic prescribing.

Purpose of the Study:

• To enhance compliance with national antibiotic guidelines for sore throat symptoms.
• To reduce inappropriate antibiotic prescribing in primary care.
• To improve patient care and combat antimicrobial resistance.

Main Methods:

• Retrospective audit of 102 patient records before interventions.
• Implementation of educational and systemic changes (automated GP electronic patient record template).
• Re-audit of 71 patient records after two Plan-Do-Study-Act (PDSA) cycles.

Main Results:

• Initial antibiotic prescribing compliance with NICE criteria was low (27% met criteria, 85% immediate prescription).
• Post-intervention, compliance with NICE criteria rose to 87%, with a reduction in immediate prescribing to 66%.
• Centor criteria documentation increased from 2% to 42%; correct antibiotic course length compliance improved from 15% to over 30%.

Conclusions:

• Automated systemic changes in electronic health records can significantly improve adherence to antibiotic guidelines.
• Interventions led to reduced immediate antibiotic prescriptions and increased documentation of assessment criteria.
• Sustainable improvements in antibiotic prescribing are achievable, contributing to antimicrobial stewardship and better patient outcomes.