A low-intensity behavioral intervention at Veterans Affairs (VA) outpatient clinics positively influenced the prescribing habits of main care suppliers (PCPs), researchers reported yesterday in Open Forum Infectious Diseases.
In a cluster randomized managed trial, a crew led by researchers with the VA Northeast Ohio Healthcare System in contrast the proportion of main care visits with an antibiotic prescription at six VA community-based outpatient clinics assigned to the intervention group and 6 to a management group. At the intervention clinics, PCPs obtained quarterly antibiotic use stories with suggestions about antibiotics for acute respiratory infections and adversarial occasion letters alerting them about Clostridioides difficile infections and antibiotic-resistant gram-negative micro organism of their sufferers.
Antibiotic prescribing was in contrast within the pre-intervention (4/2020 – 9/2020), intervention (10/2020 – 9/2021), and post-intervention intervals (9/2021–9/2022).
Control clinics prescribed extra antibiotics
Among 52 PCPs on the six clinics within the intervention group, 66% and 54% obtained a couple of antibiotic use report and adversarial occasion letter. In the intervention clinics, the proportion of main care visits with an antibiotic prescription in the course of the pre-intervention, intervention, and post-intervention intervals was 1.4%, 1.4%, and 1.3%. In the management clinics, prescribing elevated from 1.8% pre-intervention to 2.1% and a pair of.1% in the course of the intervention and post-intervention intervals.
The fee of visits with an antibiotic prescription was not statistically totally different between the intervention and management clinics within the pre-intervention interval (odds ratio [OR], 1.10; 95% confidence interval [CI], 0.87 to 1.39). But clinics within the management arm prescribed extra antibiotics in the course of the intervention (OR, 1.30; 95% CI, 1.04 to 1.62) and post-intervention intervals (OR, 1.38; 95% CI, 1.09 to 1.74). There had been no variations in emergency visits and hospitalizations between the 2 arms, indicating no unintended detrimental penalties from the intervention.
The research authors say the findings point out {that a} comparatively low-intensity intervention can help antimicrobial stewardship in outpatient settings.
“Wider implementation in a post-pandemic setting could improve antibiotic stewardship and assist lower antibiotic-resistant organisms, benefiting public well being,” they wrote.
