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Does laboratory antibiotic susceptibility reporting influence primary care prescribing in urinary tract infection and other infections?
Using a prospective interrupted time series design, our goal was to determine whether a change in urine antibiotic susceptibility reporting from co-amoxiclav to cefalexin to community clinicians served by Southmead General Hospital led to a change in antibiotic prescribing. We used longitudinal data...
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| Published in: | Journal of antimicrobial chemotherapy 2011-06, Vol.66 (6), p.1396-1404 |
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| Main Authors: | , , , , , , |
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| cited_by | cdi_FETCH-LOGICAL-c375t-5abada2285ad3618de3e1bf2398ee75b0494bf4114431caeb8eeaf47ba75fba53 |
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| cites | cdi_FETCH-LOGICAL-c375t-5abada2285ad3618de3e1bf2398ee75b0494bf4114431caeb8eeaf47ba75fba53 |
| container_end_page | 1404 |
| container_issue | 6 |
| container_start_page | 1396 |
| container_title | Journal of antimicrobial chemotherapy |
| container_volume | 66 |
| creator | MCNULTY, Cliodna A. M LASSETER, Gemma M CHARLETT, Andre LOVERING, Andy HOWELL-JONES, Rebecca MACGOWAN, Alasdair THOMAS, Mike |
| description | Using a prospective interrupted time series design, our goal was to determine whether a change in urine antibiotic susceptibility reporting from co-amoxiclav to cefalexin to community clinicians served by Southmead General Hospital led to a change in antibiotic prescribing.
We used longitudinal data on antibiotic prescribing using a clinician questionnaire to identify prescribing for urinary tract infections (UTIs) when a urine specimen was submitted to microbiology; MIQUEST computer search in general practices for prescribing for all UTIs in the community; and Prescribing Analysis and Cost (PACT) data to determine antibiotic prescribing for all infections.
Cefalexin and cephalosporin prescribing increased when cefalexin was reported and co-amoxiclav prescribing decreased when co-amoxiclav was not reported by the laboratory. This was seen for episodes of UTI in which a general practitioner (GP) sent a specimen as determined with: the questionnaire results (9-fold rise in cephalosporins, 70% fall in co-amoxiclav); episodes of UTI identified by MIQUEST searches in the practice (50% increase in cefalexin, 25% reduction in co-amoxiclav); and overall antibiotic prescribing in the practice determined with PACT data (20% increase in cefalexin, 8% reduction in co-amoxiclav). MIQUEST data indicated that prescribing reverted to pre-intervention levels once the change in antibiotic reporting had stopped.
Our data provide more evidence that changing laboratory antibiotic susceptibility reporting has a direct effect on antibiotic prescribing by GPs. Our data indicate that much of the change in prescribing was attributable to the use of cefalexin and co-amoxiclav for persistent or recurrent infections. Microbiology laboratories can influence antibiotic use by selectively reporting antibiotics they would prefer GPs to prescribe. |
| doi_str_mv | 10.1093/jac/dkr088 |
| format | article |
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We used longitudinal data on antibiotic prescribing using a clinician questionnaire to identify prescribing for urinary tract infections (UTIs) when a urine specimen was submitted to microbiology; MIQUEST computer search in general practices for prescribing for all UTIs in the community; and Prescribing Analysis and Cost (PACT) data to determine antibiotic prescribing for all infections.
Cefalexin and cephalosporin prescribing increased when cefalexin was reported and co-amoxiclav prescribing decreased when co-amoxiclav was not reported by the laboratory. This was seen for episodes of UTI in which a general practitioner (GP) sent a specimen as determined with: the questionnaire results (9-fold rise in cephalosporins, 70% fall in co-amoxiclav); episodes of UTI identified by MIQUEST searches in the practice (50% increase in cefalexin, 25% reduction in co-amoxiclav); and overall antibiotic prescribing in the practice determined with PACT data (20% increase in cefalexin, 8% reduction in co-amoxiclav). MIQUEST data indicated that prescribing reverted to pre-intervention levels once the change in antibiotic reporting had stopped.
Our data provide more evidence that changing laboratory antibiotic susceptibility reporting has a direct effect on antibiotic prescribing by GPs. Our data indicate that much of the change in prescribing was attributable to the use of cefalexin and co-amoxiclav for persistent or recurrent infections. Microbiology laboratories can influence antibiotic use by selectively reporting antibiotics they would prefer GPs to prescribe.</description><identifier>ISSN: 0305-7453</identifier><identifier>EISSN: 1460-2091</identifier><identifier>DOI: 10.1093/jac/dkr088</identifier><identifier>PMID: 21398297</identifier><identifier>CODEN: JACHDX</identifier><language>eng</language><publisher>Oxford: Oxford University Press</publisher><subject>Amoxicillin-Potassium Clavulanate Combination - therapeutic use ; Anti-Bacterial Agents - therapeutic use ; Antibiotics ; Antibiotics. Antiinfectious agents. Antiparasitic agents ; Bacterial diseases ; Bacterial diseases of the urinary system ; Biological and medical sciences ; Cephalexin - therapeutic use ; Drug Prescriptions - statistics & numerical data ; Drug Utilization - statistics & numerical data ; Health Services Research ; Human bacterial diseases ; Humans ; Infectious diseases ; Intervention ; Medical sciences ; Microbial Sensitivity Tests ; Nephrology. Urinary tract diseases ; Pharmacology. Drug treatments ; Prescription drugs ; Primary care ; Primary Health Care ; Prospective Studies ; Urinary system involvement in other diseases. Miscellaneous ; Urinary tract diseases ; Urinary Tract Infections - drug therapy ; Urinary Tract Infections - microbiology ; Urinary tract. Prostate gland</subject><ispartof>Journal of antimicrobial chemotherapy, 2011-06, Vol.66 (6), p.1396-1404</ispartof><rights>2015 INIST-CNRS</rights><rights>Copyright Oxford Publishing Limited(England) Jun 2011</rights><lds50>peer_reviewed</lds50><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c375t-5abada2285ad3618de3e1bf2398ee75b0494bf4114431caeb8eeaf47ba75fba53</citedby><cites>FETCH-LOGICAL-c375t-5abada2285ad3618de3e1bf2398ee75b0494bf4114431caeb8eeaf47ba75fba53</cites></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><link.rule.ids>315,786,790,27957,27958</link.rule.ids><backlink>$$Uhttp://pascal-francis.inist.fr/vibad/index.php?action=getRecordDetail&idt=24202441$$DView record in Pascal Francis$$Hfree_for_read</backlink><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/21398297$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>MCNULTY, Cliodna A. M</creatorcontrib><creatorcontrib>LASSETER, Gemma M</creatorcontrib><creatorcontrib>CHARLETT, Andre</creatorcontrib><creatorcontrib>LOVERING, Andy</creatorcontrib><creatorcontrib>HOWELL-JONES, Rebecca</creatorcontrib><creatorcontrib>MACGOWAN, Alasdair</creatorcontrib><creatorcontrib>THOMAS, Mike</creatorcontrib><title>Does laboratory antibiotic susceptibility reporting influence primary care prescribing in urinary tract infection and other infections?</title><title>Journal of antimicrobial chemotherapy</title><addtitle>J Antimicrob Chemother</addtitle><description>Using a prospective interrupted time series design, our goal was to determine whether a change in urine antibiotic susceptibility reporting from co-amoxiclav to cefalexin to community clinicians served by Southmead General Hospital led to a change in antibiotic prescribing.
We used longitudinal data on antibiotic prescribing using a clinician questionnaire to identify prescribing for urinary tract infections (UTIs) when a urine specimen was submitted to microbiology; MIQUEST computer search in general practices for prescribing for all UTIs in the community; and Prescribing Analysis and Cost (PACT) data to determine antibiotic prescribing for all infections.
Cefalexin and cephalosporin prescribing increased when cefalexin was reported and co-amoxiclav prescribing decreased when co-amoxiclav was not reported by the laboratory. This was seen for episodes of UTI in which a general practitioner (GP) sent a specimen as determined with: the questionnaire results (9-fold rise in cephalosporins, 70% fall in co-amoxiclav); episodes of UTI identified by MIQUEST searches in the practice (50% increase in cefalexin, 25% reduction in co-amoxiclav); and overall antibiotic prescribing in the practice determined with PACT data (20% increase in cefalexin, 8% reduction in co-amoxiclav). MIQUEST data indicated that prescribing reverted to pre-intervention levels once the change in antibiotic reporting had stopped.
Our data provide more evidence that changing laboratory antibiotic susceptibility reporting has a direct effect on antibiotic prescribing by GPs. Our data indicate that much of the change in prescribing was attributable to the use of cefalexin and co-amoxiclav for persistent or recurrent infections. Microbiology laboratories can influence antibiotic use by selectively reporting antibiotics they would prefer GPs to prescribe.</description><subject>Amoxicillin-Potassium Clavulanate Combination - therapeutic use</subject><subject>Anti-Bacterial Agents - therapeutic use</subject><subject>Antibiotics</subject><subject>Antibiotics. Antiinfectious agents. Antiparasitic agents</subject><subject>Bacterial diseases</subject><subject>Bacterial diseases of the urinary system</subject><subject>Biological and medical sciences</subject><subject>Cephalexin - therapeutic use</subject><subject>Drug Prescriptions - statistics & numerical data</subject><subject>Drug Utilization - statistics & numerical data</subject><subject>Health Services Research</subject><subject>Human bacterial diseases</subject><subject>Humans</subject><subject>Infectious diseases</subject><subject>Intervention</subject><subject>Medical sciences</subject><subject>Microbial Sensitivity Tests</subject><subject>Nephrology. Urinary tract diseases</subject><subject>Pharmacology. Drug treatments</subject><subject>Prescription drugs</subject><subject>Primary care</subject><subject>Primary Health Care</subject><subject>Prospective Studies</subject><subject>Urinary system involvement in other diseases. 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M</au><au>LASSETER, Gemma M</au><au>CHARLETT, Andre</au><au>LOVERING, Andy</au><au>HOWELL-JONES, Rebecca</au><au>MACGOWAN, Alasdair</au><au>THOMAS, Mike</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Does laboratory antibiotic susceptibility reporting influence primary care prescribing in urinary tract infection and other infections?</atitle><jtitle>Journal of antimicrobial chemotherapy</jtitle><addtitle>J Antimicrob Chemother</addtitle><date>2011-06-01</date><risdate>2011</risdate><volume>66</volume><issue>6</issue><spage>1396</spage><epage>1404</epage><pages>1396-1404</pages><issn>0305-7453</issn><eissn>1460-2091</eissn><coden>JACHDX</coden><notes>ObjectType-Article-1</notes><notes>SourceType-Scholarly Journals-1</notes><notes>ObjectType-Feature-2</notes><notes>content type line 23</notes><notes>ObjectType-Article-2</notes><notes>ObjectType-Feature-1</notes><abstract>Using a prospective interrupted time series design, our goal was to determine whether a change in urine antibiotic susceptibility reporting from co-amoxiclav to cefalexin to community clinicians served by Southmead General Hospital led to a change in antibiotic prescribing.
We used longitudinal data on antibiotic prescribing using a clinician questionnaire to identify prescribing for urinary tract infections (UTIs) when a urine specimen was submitted to microbiology; MIQUEST computer search in general practices for prescribing for all UTIs in the community; and Prescribing Analysis and Cost (PACT) data to determine antibiotic prescribing for all infections.
Cefalexin and cephalosporin prescribing increased when cefalexin was reported and co-amoxiclav prescribing decreased when co-amoxiclav was not reported by the laboratory. This was seen for episodes of UTI in which a general practitioner (GP) sent a specimen as determined with: the questionnaire results (9-fold rise in cephalosporins, 70% fall in co-amoxiclav); episodes of UTI identified by MIQUEST searches in the practice (50% increase in cefalexin, 25% reduction in co-amoxiclav); and overall antibiotic prescribing in the practice determined with PACT data (20% increase in cefalexin, 8% reduction in co-amoxiclav). MIQUEST data indicated that prescribing reverted to pre-intervention levels once the change in antibiotic reporting had stopped.
Our data provide more evidence that changing laboratory antibiotic susceptibility reporting has a direct effect on antibiotic prescribing by GPs. Our data indicate that much of the change in prescribing was attributable to the use of cefalexin and co-amoxiclav for persistent or recurrent infections. Microbiology laboratories can influence antibiotic use by selectively reporting antibiotics they would prefer GPs to prescribe.</abstract><cop>Oxford</cop><pub>Oxford University Press</pub><pmid>21398297</pmid><doi>10.1093/jac/dkr088</doi><tpages>9</tpages></addata></record> |
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| ispartof | Journal of antimicrobial chemotherapy, 2011-06, Vol.66 (6), p.1396-1404 |
| issn | 0305-7453 1460-2091 |
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| source | Oxford Journals Online |
| subjects | Amoxicillin-Potassium Clavulanate Combination - therapeutic use Anti-Bacterial Agents - therapeutic use Antibiotics Antibiotics. Antiinfectious agents. Antiparasitic agents Bacterial diseases Bacterial diseases of the urinary system Biological and medical sciences Cephalexin - therapeutic use Drug Prescriptions - statistics & numerical data Drug Utilization - statistics & numerical data Health Services Research Human bacterial diseases Humans Infectious diseases Intervention Medical sciences Microbial Sensitivity Tests Nephrology. Urinary tract diseases Pharmacology. Drug treatments Prescription drugs Primary care Primary Health Care Prospective Studies Urinary system involvement in other diseases. Miscellaneous Urinary tract diseases Urinary Tract Infections - drug therapy Urinary Tract Infections - microbiology Urinary tract. Prostate gland |
| title | Does laboratory antibiotic susceptibility reporting influence primary care prescribing in urinary tract infection and other infections? |
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