Clinical Edge

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Electronically Delivered Interventions in Antibiotic Rx

BMJ; ePub 2019 Feb 13; Gulliford, et al

Electronically delivered interventions integrated into practice workflow in a primary care setting resulted in moderate reductions of antibiotic prescribing for respiratory tract infections (RTIs) in adults, a new study found. The open label, 2-arm, cluster randomized controlled trial included 79 general practices (582,675 patient years) randomized 1:1 to antimicrobial stewardship (AMS) intervention or usual care. AMS intervention comprised a brief training webinar, automated monthly feedback reports of antibiotic prescribing, and electronic decision support tools to inform appropriate prescribing over 12 months. Intervention components were delivered electronically. The primary outcome was the rate of antibiotic prescriptions for RTIs from electronic health records (EHRs). Researchers found:

  • The trial included 41 AMS practices and 38 usual care practices.
  • Overall, the intervention was associated with moderately reduced antibiotic prescribing for RTIs in adults, with no evidence of increased serious bacterial complications.
  • The intervention reduced prescribing for adults but not for children or persons aged ≥85 years.


Gulliford MC, Prevost AT, Charlton J, et al. Effectiveness and safety of electronically delivered prescribing feedback and decision support on antibiotic use for respiratory illness in primary care. [Published online ahead of print February 13, 2019]. BMJ. doi:10.1136/bmj.l289.