Medical audit changes physicians' prescribing of antibiotics for respiratory tract infections

Objective - To reduce the prescribing of antibiotics in respiratory tract i nfections (RTI), Design and subjects - The Audit Odense model for registration and quality d evelopment was used for RTI. Twenty general practitioners registered their consultations for RTIs during 4 weeks in February-March (n = 1124) and Nove mber-December (n = 926) in 1995, Diagnosis, choice of antibiotics and diagn ostic tools were registered. In between the two registrations an active int ervention took place. Consultations for RTIs among 25 physicians (who had n ot participated in any intervention or follow-up discussion) served as a co ntrol. Setting - General practice in southern Sweden. Outcome measures - Prescribing of antibiotics before and after an intervent ion. Results-The proportion of patients not receiving an antibiotic increased fr om the first to the second registration in both groups, in the intervention group from 45 to 55% (p < 0.001) and in the control group from 36 to 40% ( p = 0.0298). The reduction was most evident in patients diagnosed with tons illitis and bronchitis. This was in concordance with an increase in the use of desktop diagnostics (Strep A and CRP). Conclusion - These results indicate that it is possible to achieve a change in the utilisation of antibiotics in the treatment of RTIs and that the Au dit Project Odense (APO) model could be a valuable fool.