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Antimicrobial stewardship

Electronic intervention in GP practices reduces antibiotic prescribing for respiratory infections

Integration of antimicrobial stewardship (AMS) interventions into GP practices reduces antibiotic prescribing for respiratory infections, research from King’s College London has found

The study, published in The BMJ, used data from UK electronic health records to evaluate the effectiveness and safety of an antimicrobial stewardship intervention comprising a training webinar, monthly feedback of antibiotic prescribing data and electronic decision support tools in 79 GP practices.

After 12 months, the AMS intervention led to a 12% overall reduction in antibiotic prescribing for respiratory infections compared to usual care, with no evidence of increased rates of serious bacterial complications such as pneumonia.

The most notable reduction in antibiotic prescribing was in people aged 15–84 years, with one antibiotic prescription per year avoided for every 62 patients.

However, there was no evidence of effect for people aged less than than 15 years or over 85 years.

The researchers concluded that electronically-delivered interventions integrated into practice workflow resulted in a moderate reduction of antibiotic prescribing for respiratory tract infections in adults, but that antibiotic prescribing in very young or older patients required further evaluation.

“Misuse of antibiotics is putting us all at risk. Taking antibiotics when they are not needed is leading to the emergence of resistant infections that can be very difficult to treat,” said Martin Gulliford, professor of public health at King’s College London and lead author of the study.

“This trial showed that providing GPs with information about their use of antibiotics for respiratory illnesses led to a reduction in antibiotic use. If this approach is scaled up nationally, it could contribute to reducing the emergence of antibiotic resistance.”

The intervention was also low-cost — the budget for the trial was £533,580, which, the researchers noted, meant that the research and intervention were delivered for less than £1 per patient year.

Citation: The Pharmaceutical Journal DOI: 10.1211/PJ.2019.20206148

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