Cited by 96Antibiotic Use and ResistanceHealthcare cost, quality, practicesClinical practice guidelines implementation

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

Coenen, Samuel, Van Royen, Paul, Michiels, Barbara, Denekens, Joke·2004·Journal of Antimicrobial Chemotherapy

Abstract

OBJECTIVES: To assess the effect of a tailored professional intervention, including academic detailing, on antibiotic prescribing for acute cough. METHODS: In a cluster-randomized controlled before and after study 85 Flemish GPs included adult patients with acute cough consulting in the periods February-April 2000 and 2001. The intervention consisted of a clinical practice guideline for acute cough, an educational outreach visit and a postal reminder to support its implementation in January 2001. Antibiotic prescribing rates and patients' symptom resolution were the main outcome measures. RESULTS: Thirty-six of 42 GPs received the intervention and 35 of 43 GPs served as controls; 1503 patients were eligible for analysis. Only in the intervention group were patients less likely to receive antibiotics after the intervention [OR(adj) (95% CI)=0.56 (0.36-0.87)]. Prescribed antibiotics were also more in line with the guideline in the intervention group [1.90 (0.96-3.75)] and less expensive from the perspective of the National Sickness and Invalidity Insurance Institute [MD(adj) (95% CI)= Euro -6.89 [-11.77-(-2.02)]]. No significant differences were found between the groups for the time to symptom resolution. CONCLUSIONS: An (inter)actively delivered tailored intervention implementing a guideline for acute cough is successful in optimizing antibiotic prescribing without affecting patients' symptom resolution. Further research efforts should be devoted to cost-effectiveness studies of such interventions.

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Crossref · 10.1093/jac/dkh374

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Authors
Coenen, S., Van Royen, P., Michiels, B., & Denekens, J.
Affiliations
University of Antwerp (BE)
Corresponding author
Coenen, Samuel
Venue
Journal of Antimicrobial Chemotherapy
Published
2004-09-01
Volume
54
Issue
3
Pages
661-672
ISSN
  • 0305-7453 (ISSN-L)
  • 1460-2091
OpenAlex
W2106918076
Cited by
96
References
56
Citations by year
2026: 2 · 2025: 2 · 2024: 1 · 2023: 4 · 2022: 3 · 2021: 10 · 2020: 4 · 2019: 3 · 2018: 4 · 2016: 3 · 2015: 2 · 2014: 9 · 2013: 6 · 2012: 7
FWCI
6.45
Type
journal article
Language
en
Open access
closed
Locations
  • Journal of Antimicrobial Chemotherapy (publishedVersion)
  • PubMed (publishedVersion)
  • HighWire Press Open Archive (submittedVersion)
Funders
Belgische Federale Overheidsdiensten
Topics
  • Life Sciences › Immunology and Microbiology › Applied Microbiology and Biotechnology › Antibiotic Use and Resistance
  • Health Sciences › Health Professions › General Health Professions › Healthcare cost, quality, practices
  • Health Sciences › Medicine › Public Health, Environmental and Occupational Health › Clinical practice guidelines implementation
Keywords
acute cough, antibiotic prescribing, inappropriate antibiotic use, academic detailing, general practitioners, guideline implementation, educational outreach, symptom resolution, prescription drug costs, primary care
MeSH terms
Acute Disease, Adult, Anti-Bacterial Agents, Belgium, Cough, Data Collection, Family Practice, Female, Humans, Male, Drug Prescriptions, Surveys and Questionnaires, Risk Factors, Cluster Analysis, Drug Costs, Treatment Outcome, Guidelines as Topic, Sample Size

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