RT journal article
T1 Improving the appropriateness of antimicrobial use in primary care after implementation of a local antimicrobial guide in both levels of care
A1 Fernández Urrusuno, Rocío
A1 Flores Dorado, Macarena
A1 Vilches-Arenas, Ángel
A1 Serrano Martino, Carmen
A1 Corral Baena, Susana
A1 Montero Balosa, Mª Carmen
A2 BiomedicinaBiotecnología y Salud Pública
K1 Appropriate prescription
K1 Antibiotics
K1 Infections
K1 Multifaceted interventions
K1 Primary care
AB Objective This study aims to assess the effectiveness of multiple interventions carried out during the implementation of a guide, on the improvement of the appropriateness of antimicrobial prescribing in primary care.Design This is a cross-sectional before/after study carried out in Aljarafe Health Care Area (Andalusia, Spain), with a population of 368,728 inhabitants assisted in 37 health centers.Subjects Subjects include patients with antibiotic prescriptions during 2009 (pre-intervention phase) or 2012 (postintervention phase) selected by simple random sampling (confidence level, 95 %; accuracy, 5 %), with infections registered in the electronic clinical history.Interventions This study involve training sessions in primary care centers and hospital services, incorporation of the electronic guide to the Health Care Service Websites, andincorporation of the guide to the Digital Health History as a tool to support decision making.Main outcome Difference on appropriate antibiotic prescribing before and after interventions resulted from the study.Other variables also include age, gender, type of pharmacy, antibiotic prescribed, number of treatments per year, infection site, and main comorbidities Sources In addition, this study uses computerized pharmacy records of reimbursed and dispensed drugs and electronic medical histories.Results The percentage of appropriate antibiotic prescribing increased from 36 % in 2009 to 57 % in 2012 (p<0.001) is shown. The improvement was observed in all age patients of any sex and was higher among working-age patients and patients with comorbidities. The best results were observedin the group of beta-lactams and in the treatment of respiratory and skin infections.Conclusion The realization of multifactorial interventions involving professionals from both levels of care could be an effective strategy to improve the use of antimicrobials in primary care.
PB Springer
SN 0031-6970
YR 2014
FD 2014
LK http://hdl.handle.net/10498/34506
UL http://hdl.handle.net/10498/34506
LA eng
NO This investigation was financially supported by two research projects: FISS Spanish Ministry of Health (project PI/10/01152) andAndalusian Regional Ministry of Health (project PI-0160-2010).
DS Repositorio Institucional de la Universidad de Cádiz
RD 14-nov-2026