An evaluation of statewide strategies to reduce antibiotic overuse.

摘要: Background The rapid increase of antibiotic resistance poses a significant threat to human health. Overuse antibiotics has been linked rates resistance. This study assessed the utility two common interventions--1) practice profiling and feedback 2) patient education materials--implemented decrease prescribing for pediatric upper respiratory infections (URIs). Methods Based on Medicaid regions in Kentucky, primary care physicians managing were randomized into four groups. Groups received either 1) performance only, materials 3) both materials, or 4) no intervention. Participating had their period July 1, 1996, November 30, 1997, with an intervention June 1997. included 216 124,092 episodes care. Results All groups increased proportion between pre-intervention post-intervention periods. Prescribing group at significantly lower rate than control group. Physicians did not change coding illness justify after intervention, there was generalization effect adult URIs. Conclusions These interventions demonstrate little if any impact promoting appropriate prescribing. Antibiotic viral continues increase, suggesting concomitant increases