Patient, physician education can cut inappropriate antibiotics by 31%

Educating physicians and patients about safe antibiotic practices could cut inappropriate prescriptions by nearly one-third, according to a study published in Academic Emergency Medicine.

Researchers from Sacramento, Calif.-based UC Davis Health conducted the CDC-funded study. They randomly assigned 292 clinicians at nine emergency departments and urgent care centers in California and Colorado to use one of two educational strategies to reduce antibiotic use. Researchers then reviewed 44,820 patient visits for viral acute respiratory infections to track the number of inappropriate antibiotics administered to patients between 2017 and 2018.

One approach involved giving patients and providers educational materials on safe antibiotic use, while also designating a physician to champion the efforts. The second approach gave physicians behavioral "nudges," in which they received feedback on prescribing rates and saw how they compared to peers.

In total, antibiotic prescriptions for viral infections fell from 6.2 percent to 2.4 percent during the study period. Researchers found inappropriate prescriptions dropped from 2.2 percent to 1.5 percent over the same period, marking a 31.8 percent decrease. The second, more aggressive educational approach involving behavioral nudges was not more effective at reducing antibiotic overuse.

"We found education with an on-site champion reduced inappropriate antibiotic use by a third across the board," Larissa May, MD, senior author and professor of emergency medicine at UC Davis Health, said in a press release. "Our study shows that this relatively simple approach can get us to near-zero inappropriate antibiotic use for acute respiratory infections."

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