The mass use of antibiotics has caused a rise of bacterial resistance to these drugs that is threatening to destroy the power of these life saving drugs. Two separate systematic reviews published this week in The Cochrane Library show how appropriate interventions in hospitals and doctors' offices can result in improvements in the ways doctors prescribe antibiotics and may lead to a reduction in resistant bacteria.
A systematic review of 66 different studies showed that improving the way that antibiotics are prescribed in hospital to inpatients can reduce antibiotic resistance and hospital acquired infection.
The Cochrane Review Authors divided interventions into those that sought to educate or persuade staff to change their prescribing behaviour, and those that imposed a restrictive set of guidelines or orders. An example of this is that some interventions restricted the range of antibiotics that physicians in the hospital could prescribe, while other persuasive interventions got hospital pharmacists to recommend alternative antibiotics to those initially requested.
Other examples of frequently used persuasive techniques were various forms of lectures, seminars and case reviews with all grades of medical and nursing staff.
The authors found that restrictive interventions had a greater immediate impact than persuasive interventions. "But hospitals should resist the temptation to adopt restrictive interventions without evaluating their long-term effects, particularly on clinical outcomes," says lead author Peter Davey who works at Ninewells Hospital and Medical School, Dundee.
"Interestingly, we found that interventions are less likely to be successful if there is evidence that practice is already changing in the desired direction," says Davey.
In Doctors' Offices
A systematic review of 39 studies showed that attitudes towards prescribing were most powerfully changed if the intPage: 1 2 Related medicine news :1
Contact: Amy Molnar
John Wiley & Sons, Inc.
. Vicente Fox Center and RAND launch joint program to find policies to combat poverty2
. Smoking, growing private hospital care for poor and US flu vaccine policies3
. ACP challenges Congress to make fundamental changes in Medicare payment policies4
. Outdated policies are impediment for Americans with disabilities5
. A system in need of change -- restructuring payment policies to support patient-centered care6
. Restrictive provincial drug policies may have benefits7
. UCLA study reports conflict of interest policies and practices of major journals8
. Focus on opticians shows chain store pricing policies can save independents9
. Political party policies to reduce social inequalities have better health outcomes10
. Ireland leads Europe for anti-tobacco policies while Luxembourg comes last11
. Heart rhythm society issues draft recommendations on performance policies for pacemakers and ICDs