Type

Journal Article

Authors

Andrew W Murphy
Christine Domegan
Martin Cormican
Kathleen Bennett
Aoife Callan
Sinead Duane
Sandra Galvin
Akke Vellinga

Subjects

Veterinary

Topics
odds ratio urinary tract complex intervention urinary tract infections general practice antimicrobial resistance antimicrobial prescribing infection

Intervention to improve the quality of antimicrobial prescribing for urinary tract infection: a cluster randomized trial. (2015)

Abstract Overuse of antimicrobial therapy in the community adds to the global spread of antimicrobial resistance, which is jeopardizing the treatment of common infections. We designed a cluster randomized complex intervention to improve antimicrobial prescribing for urinary tract infection in Irish general practice. During a 3-month baseline period, all practices received a workshop to promote consultation coding for urinary tract infections. Practices in intervention arms A and B received a second workshop with information on antimicrobial prescribing guidelines and a practice audit report (baseline data). Practices in intervention arm B received additional evidence on delayed prescribing of antimicrobials for suspected urinary tract infection. A reminder integrated into the patient management software suggested first-line treatment and, for practices in arm B, delayed prescribing. Over the 6-month intervention, practices in arms A and B received monthly audit reports of antimicrobial prescribing. The proportion of antimicrobial prescribing according to guidelines for urinary tract infection increased in arms A and B relative to control (adjusted overall odds ratio [OR] 2.3, 95% confidence interval [CI] 1.7 to 3.2; arm A adjusted OR 2.7, 95% CI 1.8 to 4.1; arm B adjusted OR 2.0, 95% CI 1.3 to 3.0). An unintended increase in antimicrobial prescribing was observed in the intervention arms relative to control (arm A adjusted OR 2.2, 95% CI 1.2 to 4.0; arm B adjusted OR 1.4, 95% CI 0.9 to 2.1). Improvements in guidelinebased prescribing were sustained at 5 months after the intervention. A complex intervention, including audit reports and reminders, improved the quality of prescribing for urinary tract infection in Irish general practice. ClinicalTrials.gov, no. NCT01913860.
Collections Ireland -> Trinity College Dublin -> PubMed

Full list of authors on original publication

Andrew W Murphy, Christine Domegan, Martin Cormican, Kathleen Bennett, Aoife Callan, Sinead Duane, Sandra Galvin, Akke Vellinga

Experts in our system

1
Andrew W. Murphy
National University of Ireland Galway
Total Publications: 91
 
2
Martin Cormican
National University of Ireland Galway
Total Publications: 51
 
3
Kathleen Bennett
Royal College of Surgeons in Ireland
Total Publications: 135
 
4
Akke Vellinga
National University of Ireland Galway
Total Publications: 21