• Carl Llor, Lars Bjerrum, José M Molero, Ana Moragas, Beatriz González López-Valcárcel, M José Monedero, Manuel Gómez, Marina Cid, Alcántara Juan de Dios JD Bollulos Par del Condado Health Centre, Huelva, Spain., Josep M Cots, Joana M Ribas, Guillermo García, Jesús Ortega, Vicenta Pineda, Gloria Guerra, Susana Munuera, and HAPPY AUDIT 3 Study Team.
• Via Roma Health Centre, Barcelona, Spain.
• J. Antimicrob. Chemother. 2018 Aug 1; 73 (8): 2215-2222.

ObjectivesFew studies have evaluated the long-term effects of educational interventions on antibiotic prescription and the results are controversial. This study was aimed at assessing the effect of a multifaceted practice-based intervention carried out 6 years earlier on current antibiotic prescription for respiratory tract infections (RTIs).MethodsThe 210 general practitioners (GPs) who completed the first two registrations in 2008 and 2009 were invited to participate in a third registration. The intervention held before the second registration consisted of discussion about the first registration of results, appropriate use of antibiotics for RTIs, patient brochures, a workshop and the provision of rapid tests. As in the previous registrations, GPs were instructed to complete a template for all the patients with RTIs during 15 working days in 2015. A new group of GPs from the same areas was also invited to participate and acted as controls. A multilevel logistic regression analysis was performed considering the prescription of antibiotics as the dependent variable.ResultsA total of 121 GPs included in the 2009 intervention (57.6%) and 117 control GPs registered 22 247 RTIs. On adjustment for covariables, compared with the antibiotic prescription observed just after the intervention, GPs assigned to intervention prescribed slightly more antibiotics 6 years later albeit without statistically significant differences (OR 1.08, 95% CI 0.89-1.31, P = 0.46), while GPs in the control group prescribed significantly more antibiotics (OR 2.74, 95% CI 2.09-3.59, P < 0.001).ConclusionsThis study shows that a single multifaceted intervention continues to reduce antibiotic prescribing 6 years later.

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