title: Peer academic detailing on use of antibiotics in acute respiratory tract infections. A controlled study in an urban Norwegian out-of-hours service.
abstract: OBJECTIVE
  To analyse if peer academic detailing by experienced general practitioners (GPs) could be a useful way to change Medical Doctors, (MDs) prescription of antibiotics for acute respiratory tract infections (ARTIs) in out-of-hours service.
  
  
  METHODS
  An educational Intervention study based on prescription data among MDs working in an out-of-hours service from June 2006 through October 2008. Specially trained GPs lectured a peer educational program (3 × 45 minutes) about use of antibiotics for ARTIs according to national recommendations.
  
  
  METHODS
  The type and frequency of antibiotics prescribed for different ARTIs before and after intervention comparing the intervention group with the control group.
  
  
  METHODS
  22 MDs in the intervention group and 31 MDs in the control group.
  
  
  RESULTS
  The intervention group showed an overall statistically significantly absolute increase in the use of penicillin V (Penicillin V) of 9.8% (95% CI: 2.3%-17.4% p < 0.05), and similarly an statistically significantly absolute decrease in the use of macrolides and lincosamides of 8.8% (95% CI: 2.6%-14.9.2% p < 0.05) for all diagnoses. For subgroups of ARTIs we found a significant increase in the use of Penicillin V for acute otitis media, sinusitis, pneumonia and upper ARTIs. There was no significant changes in total prescription rates in the two groups. 41% of all consultations with respiratory tract infections resulted in antibiotic prescription.
  
  
  CONCLUSIONS
  Using trained GPs to give peer academic detailing to colleagues in combination with open discussion on prescription, showed a significant change in prescription of antibiotics towards national guidelines. Key points Phenoxymethylpenicillin is the first choice for the most of respiratory tract infections when indicated. Despite the guidelines for the choice of antibiotics in Norway, general practitioners' choice often differs from these. We showed that a session of three times 45 min of peer academic detailing changed significantly the choice of antibiotics towards the National Guidelines in an urban Norwegian out-of-hours service.
authors.affiliation: a Department of Clinical Pharmacology , St. Olavs Hospital , Trondheim , Norway ;
authors.forename: Roar
authors.initials: R
authors.lastname: Dyrkorn
authors.affiliation: b Department of General Practice, Antibiotic centre for primary care , Institute for health and society, University of Oslo , Oslo , Norway.
authors.forename: Svein
authors.initials: S
authors.lastname: Gjelstad
authors.affiliation: a Department of Clinical Pharmacology , St. Olavs Hospital , Trondheim , Norway ;
authors.forename: Ketil Arne
authors.initials: KA
authors.lastname: Espnes
authors.affiliation: b Department of General Practice, Antibiotic centre for primary care , Institute for health and society, University of Oslo , Oslo , Norway.
authors.forename: Morten
authors.initials: M
authors.lastname: Lindbæk
mesh_terms: D000328:Adult; D039602:After-Hours Care; D000900:Anti-Bacterial Agents / Q000627:therapeutic use*; D004363:Drug Utilization / Q000706:statistics & numerical data*; D005260:Female; D058005:General Practitioners; D006801:Humans; D008297:Male; D008875:Middle Aged; D009664:Norway; D010379:Peer Group; D010404:Penicillin V / Q000627:therapeutic use; D010818:Practice Patterns, Physicians' / Q000706:statistics & numerical data*; D012044:Regression Analysis; D012141:Respiratory Tract Infections / Q000188:drug therapy*
chemical_list: D000900:Anti-Bacterial Agents; D010404:Penicillin V
keywords: Antibiotic prescriptions; Norway; general practice; out-of-hours service; peer academic detailing; respiratory tract infections