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 ORIGINAL ARTICLE
Year : 2015  |  Volume : 33  |  Issue : 2  |  Page : 255-259

Impact of informational feedback to clinicians on antibiotic-prescribing rates in a tertiary care hospital in Delhi


1 Department of Clinical Microbiology and Immunology, Sir Ganga Ram Hospital, New Delhi, India
2 Department of Medicine, Sir Ganga Ram Hospital, New Delhi, India
3 Department of Research and Policy, Director, Center for Disease Dynamics, Economics and Policy, Washington, USA; Vice President, Public Health Foundation of India, India
4 Department of Infectious Disease Epidemiology, PhD Candidate, Imperial College London, London, United Kingdom

Correspondence Address:
C Wattal
Department of Clinical Microbiology and Immunology, Sir Ganga Ram Hospital, New Delhi
India
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Source of Support: The study was financially supported by Center for Disease Dynamics, Economics & Policy, Washington, DC, Conflict of Interest: None


DOI: 10.4103/0255-0857.153582

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Context: Antimicrobial use has been associated with increasing antimicrobial resistance. There is an urgent need for judicious use of antimicrobials. Informational feedback has been shown to result in changes in behavioural practices of physicians in certain healthcare settings. We conducted this study to see if the passive informational feedback can reduce in antimicrobial usage in a tertiary care centre. Aims: The study was undertaken to evaluate if the feedback to clinicians on their own antibiotic prescription results in any change in their antibiotic prescription habits. Settings and Design: The study was conducted at a tertiary care setting involving 33 units of different specialties. These units were split into 10 groups based on specialty and were allocated randomly to the control (16 units) and intervention (17 units) arms of the study. This study was a prospective intervention to assess the effect of prescribing feedback on clinical prescribing practices. Materials and Methods: In the intervention arm, information on resistance rates and antibiotic-prescribing patterns was provided to all doctors. Behavioural change was assessed by comparing baseline prescribing rates of each unit with prescribing rates after the intervention. In the control arm, only information on monthly resistance rates was provided. Statistical Analysis : Change in the antimicrobial prescribing rates in the treatment group was assessed by using a Student's t-test. Results: The mean antibiotic use for all the specialties was 189 DDDs/100BDs. The prospective intervention did not elicit any effect on the antibiotic prescribing practices of the physicians. Low prescribers continued to prescribe antibiotics at a low rate, and high prescribers continued to prescribe at a high rate. Conclusions: In view of unfavourable results of passive intervention in the above study, active intervention may be more effective.






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2004 - Indian Journal of Medical Microbiology
Published by Wolters Kluwer - Medknow

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