Improving the prescribing of antibiotics for urinary tract infection.
BACKGROUND
In recent years there have been changes in the recommended antibiotic treatment for urinary tract infections (UTIs). In particular, the use of amoxycillin or co-trimoxazole is now discouraged, with amoxycillin-potassium clavulanate, cephalexin and trimethoprim becoming first-line agents for uncomplicated lower UTIs.


OBJECTIVE
To examine whether academic detailing, performed by a pharmacist, could modify prescribing practices for antibiotics used in the treatment of UTI in the community setting.


METHODS
The intervention was conducted in Southern Tasmania, using the remainder of the State as a control area. The target group of general practitioners was sent educational material designed to assist in the appropriate prescribing of antibiotics in the treatment of UTI. A pharmacist then visited each general practitioner and discussed the rational use of antibiotics for UTIs directly with him/her. Outcomes were measured using evaluation feedback from the general practitioners and pharmacoepidemiological data, which were not linked to diagnosis. The key variable examined was the total defined daily doses (DDDs) dispensed for the recommended first-line agents (amoxycillin-potassium clavulanate, cephalexin and trimethoprim) compared with amoxycillin (3 g single-dose form) and co-trimoxazole.


RESULTS
The educational programme was very well received by the general practitioners. Changes in the prescribing of antibiotics commonly used for UTIs were evident in both study regions over the course of the study, but the improvements were significantly greater in the intervention area.


CONCLUSIONS
Educational programmes utilizing academic detailing by pharmacists can modify prescribing practices within the community setting.
Peterson
G M
GM
Tasmanian School of Pharmacy, Faculty of Medicine and Pharmacy, University of Tasmania, Hobart, Australia.
Stanton
L A
LA
Bergin
J K
JK
Chapman
G A
GA
D000892:Anti-Infective Agents, Urinary / Q000627:therapeutic use*; D004502:Education, Medical, Continuing; D005194:Family Practice / Q000193:education*; D006801:Humans; D010595:Pharmacists; D013648:Tasmania / Q000453:epidemiology; D014552:Urinary Tract Infections / Q000188:drug therapy*
D000892:Anti-Infective Agents, Urinary