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Effectiveness of GP online training and an information booklet for parents on antibiotic prescribing for children with RTI in primary care: a cluster randomised controlled trial

Dekker, Anne R.J., Verheij, Theo J.M., Broekhuizen, Berna D.L., Butler, Christopher C, Cals, Jochen W.L., Francis, Nicholas, Little, Paul, Sanders, Elisabeth A.M., Yardley, Lucy, Zuithoff, Nicolaas P.A. and Van Der Velden, Alike W. 2018. Effectiveness of GP online training and an information booklet for parents on antibiotic prescribing for children with RTI in primary care: a cluster randomised controlled trial. Journal of Antimicrobial Chemotherapy 73 (5) , pp. 1416-1422. 10.1093/jac/dkx542

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Abstract

OBJECTIVES: Antibiotics are too often prescribed in childhood respiratory tract infection (RTI), despite limited effectiveness, potential side effects and bacterial resistance. We aimed to reduce antibiotic prescribing for children with RTI by online training for general practitioners (GPs) and information for parents. METHODS: A pragmatic cluster randomized controlled trial in primary care. The intervention consisted of online training for GPs and an information booklet for parents. The primary outcome was the antibiotic prescription rate for children presenting with RTI symptoms, as registered by GPs. Secondary outcomes were number of reconsultations within the same disease episode, consultations for new episodes, hospital referrals and pharmacy-dispensed antibiotic courses for children. This trial was registered at the Dutch Trial Register (NTR), registration number: NTR4240. RESULTS: After randomization, GPs from a total of 32 general practices registered 1009 consultations. An antibiotic was prescribed in 21% of consultations in the intervention group, compared with 33% in the usual care group, controlled for baseline prescribing (rate ratio 0.65, 95% CI 0.46-0.91). The probability of reconsulting during the same RTI episode did not differ significantly between the intervention and control groups, and nor did the numbers of consultations for new episodes and hospital referrals. In the intervention group antibiotic dispensing was 32 courses per 1000 children/year lower than the control group, adjusted for baseline prescribing (rate ratio 0.78, 95% CI 0.66-0.92). The numbers and proportion of second-choice antibiotics did not differ significantly. CONCLUSIONS: Concise, feasible, online GP training, with an information booklet for parents, showed a relevant reduction in antibiotic prescribing for children with RTI.

Item Type: Article
Date Type: Publication
Status: Published
Schools: Medicine
Publisher: Oxford University Press
ISSN: 0305-7453
Funders: Netherlands Organization for Health Research and Development
Date of First Compliant Deposit: 4 January 2018
Date of Acceptance: 25 December 2017
Last Modified: 18 Oct 2019 23:00
URI: http://orca.cf.ac.uk/id/eprint/107875

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