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IDSA: Docs Need Feedback to Keep Good Prescribing Habits

Clinicians in the ambulatory setting need continued feedback to maintain antimicrobial stewardship

FRIDAY, Oct. 10, 2014 (HealthDay News) -- Benefits of an outpatient antimicrobial stewardship intervention were lost after audit and feedback to clinicians was removed, according to research published online Oct. 10 in the Journal of the American Medical Association. The research was published to coincide with the annual meeting of the Infectious Diseases Society of America (IDWeek), held from Oct. 8 to 12 in Philadelphia.

Jeffrey S. Gerber, M.D., Ph.D., of the Children's Hospital of Philadelphia, and colleagues assessed the durability of an outpatient antimicrobial stewardship intervention conducted at 18 community-based pediatric primary care practices. At 18 months after termination of audit and feedback for the intervention, antibiotic prescribing was compared at intervention and control sites.

The researchers found, in the primary study, that prescribing of broad-spectrum antibiotics decreased after a 12-month intervention of prescribing audit and feedback. Following termination of audit and feedback, the prescribing of broad-spectrum antibiotics increased over time and returned to above-baseline levels. The data set was restandardized for an additional 18 months of data. For the intervention group, antibiotic prescribing increased from 16.7 percent at the completion of the intervention to 27.9 percent at the end of the observation period. For the control group, antibiotic prescribing increased from 25.4 to 30.2 percent during the observation period (difference of differences between the groups, −6.4 percent; P = 0.02 for differences in trajectories).

"Our findings suggest that extending antimicrobial stewardship to the ambulatory setting can be effective but should include continued feedback to clinicians," the authors write.

Two authors disclosed financial ties to Pfizer.

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