Journal Article

Effect of Changes in Antibiotic Prescribing on Patient Outcomes in a Community Setting: A Natural Experiment in Australia

Justin Beilby, John Marley, Don Walker, Nicole Chamberlain and Burke Michelle

in Clinical Infectious Diseases

Published on behalf of Infectious Diseases Society of America

Volume 34, issue 1, pages 55-64
Published in print January 2002 | ISSN: 1058-4838
Published online January 2002 | e-ISSN: 1537-6591 | DOI: http://dx.doi.org/10.1086/338232
Effect of Changes in Antibiotic Prescribing on Patient Outcomes in a Community Setting: A Natural Experiment in Australia

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  • Infectious Diseases
  • Immunology
  • Public Health and Epidemiology
  • Microbiology

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This study examined whether a significant change in antibiotic use caused by an Australian government directive targeted at amoxicillin with clavulanic acid (AC) was associated with changes in prescription share, health care costs, and patient outcomes. We used an integrated database of computerized general practice medical records, which included data regarding 34,242 patients and 318,234 recorded patient visits. There were 15,303 antibiotic prescriptions provided to 9921 patients during a 4-year period, with AC prescribed for 1453 (14.6%) of these patients. A total of 5125 patient outcomes were identified. There was a shift away from best-practice antibiotic prescribing, and a significant association was identified between the rate and cost of process-of-care and patient outcomes and the decrease in AC-prescription share. This policy initiative created unintended changes in prescribing behavior, increased costs to the government, and a trend toward poorer patient outcomes. Detailed analyses are required before instigating initiatives aimed at changing clinicians' prescribing behavior.

Journal Article.  5944 words.  Illustrated.

Subjects: Infectious Diseases ; Immunology ; Public Health and Epidemiology ; Microbiology

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