Relationship between antimicrobial-resistance programs and antibiotic dispensing for upper respiratory tract infection: An analysis of Australian data between 2004 and 2015 - PubMed (original) (raw)

Relationship between antimicrobial-resistance programs and antibiotic dispensing for upper respiratory tract infection: An analysis of Australian data between 2004 and 2015

Jianyun Wu et al. J Int Med Res. 2018 Apr.

Abstract

Objective NPS MedicineWise aims to ensure that medicines are prescribed and used in a manner consistent with current evidence-based best practice. A series of nationwide educational and advertising interventions for general practitioners and consumers were implemented in Australia between 2009 and 2015 with the aim of reducing antibiotic prescriptions for upper respiratory tract infections (URTIs). The work described in this paper quantifies the change in antibiotic dispensing following these interventions. Methods Antibiotic dispensing data between 2004 and 2015 were obtained from a national claims database. A Bayesian structural time series model was used to forecast a series of antibiotic dispensing volumes expected to have occurred if the interventions had not taken place. These were compared with the volumes that were actually observed to estimate the intervention effect. Results On average, 126,536 fewer antibiotics were dispensed each month since the intervention programs began in 2009 (95% Bayesian credible interval = 71,580-181,490). This change represents a 14% total reduction in dispensed scripts after the series of intervention programs began in 2009. Conclusions Continual educational intervention programs that emphasise the judicious use of antibiotics may effectively reduce inappropriate prescribing of antibiotics for the treatment of URTIs at a national level.

Keywords: Evaluation; antibiotic dispensing; antimicrobial resistance; general practitioners; intervention; primary health care.

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Figures

Figure 1.

Figure 1.

(a) Observed (black) vs. estimated (solid blue) dispensing volumes of GP-prescribed antibiotics vs. expected (dashed blue) dispensing volumes as if without the interventions. (b) Time series of dispensing volumes prescribed by other health practitioners (used as a predictor) and (c) estimated monthly reduction in antibiotic dispensing volume. Additional panels on the left of (a) and (b) show the dispensing volumes of GP-prescribed and other health practitioner-prescribed antibiotics prior to the study period. The blue shaded areas are the 95% Bayesian credible intervals (95% BCI). The dashed vertical lines indicate the launch of the programs. The right-arrow at the top of panel (a) indicates that the 2012 intervention was ongoing beyond the end of the study period in June 2015.

Figure 2.

Figure 2.

Mean antibiotic dispensing rates per GP (black) and per other health practitioner (red). The launch of the programs is indicated by the dashed vertical lines. The right-arrow at the top of the panel indicates that the 2012 intervention was ongoing beyond the end of the study period in June 2015.

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