title: Effect of two interventions on reducing antibiotic prescription in pharyngitis in primary care.
abstract: OBJECTIVE
  to evaluate the effect of two interventions on reducing antibiotic prescription in pharyngitis.
  
  
  METHODS
  a prospective, non-randomized, before-after controlled study was carried out in primary care centres throughout Spain. General practitioners (GPs) registered all cases of pharyngitis during a 3 week period before and after two types of intervention in 2008 and 2009, respectively. Full intervention consisted of discussion sessions of the results of the first registry, courses for GPs, guidelines, patient information leaflets, workshops on rapid tests and the use of rapid antigen detection tests (RADTs) in their consulting offices. The physicians in the partial intervention group underwent all the above intervention except for the workshop, and RADTs were not provided. A control group was also included in 2009. Multilevel logistic regression was performed considering the prescription of antibiotics as the dependent variable.
  
  
  RESULTS
  a total of 280 GPs registered cases with pharyngitis (70 partial intervention and 210 full intervention). Fifty-nine new physicians were included as a control group. A total of 6849 episodes of pharyngitis were registered. Antibiotic prescription was significantly lower after intervention for the full intervention group, but not for the partial intervention group. According to the multivariate model, in comparison with the control group, the odds ratio of antibiotic prescription after the intervention was 0.52 [95% confidence interval (95% CI) 0.23-1.18] in the partial intervention group and 0.23 (95% CI 0.11-0.47) in the full intervention group.
  
  
  CONCLUSIONS
  intervention was beneficial for reducing the prescription of antibiotics, but was only statistically significant when the GPs were provided with RADTs.
authors.affiliation: University Rovira i Virgili, Primary Healthcare Centre Jaume I, Tarragona, Spain. carles.llor@urv.cat
authors.forename: Carl
authors.initials: C
authors.lastname: Llor
authors.forename: Josep María
authors.initials: JM
authors.lastname: Cots
authors.forename: Beatriz
authors.initials: B
authors.lastname: González López-Valcárcel
authors.forename: Juan de Dios
authors.initials: Jde D
authors.lastname: Alcántara
authors.forename: Guillermo
authors.initials: G
authors.lastname: García
authors.forename: Javier
authors.initials: J
authors.lastname: Arranz
authors.forename: María José
authors.initials: MJ
authors.lastname: Monedero
authors.forename: Jesús
authors.initials: J
authors.lastname: Ortega
authors.forename: Vicenta
authors.initials: V
authors.lastname: Pineda
authors.forename: Gloria
authors.initials: G
authors.lastname: Guerra
authors.forename: Manuel
authors.initials: M
authors.lastname: Gómez
authors.forename: Silvia
authors.initials: S
authors.lastname: Hernández
authors.forename: José
authors.initials: J
authors.lastname: Paredes
authors.forename: Marina
authors.initials: M
authors.lastname: Cid
authors.forename: Carolina
authors.initials: C
authors.lastname: Pérez
mesh_terms: D000900:Anti-Bacterial Agents / Q000627:therapeutic use*; D003141:Communicable Diseases / Q000175:diagnosis; D004363:Drug Utilization / Q000706:statistics & numerical data*; D006801:Humans; D025202:Molecular Diagnostic Techniques / Q000379:methods / Q000706:statistics & numerical data; D010612:Pharyngitis / Q000188:drug therapy*; D055656:Prescriptions / Q000706:statistics & numerical data*; D011320:Primary Health Care / Q000379:methods*; D011446:Prospective Studies; D013030:Spain
chemical_list: D000900:Anti-Bacterial Agents