Improving the quality of antibiotic prescription patterns in general practice. The role of educational intervention.

OBJECTIVE: To assess the quality of antibiotic prescribing by Victorian general practitioners, and the effectiveness of educational intervention techniques in improving prescribing. DESIGN: A randomised, controlled, parallel group trial. SETTING AND PARTICIPANTS: In rural and metropolitan Victoria, 182 general practitioners (78 control, 104 intervention) began and 103 (41 control, 62 intervention) completed the study. INTERVENTION: Participants recorded their antibiotic prescribing for tonsillitis. The intervention group received an educational mailing campaign. A project pharmacist visited each doctor to discuss campaign messages. MAIN OUTCOME MEASURE: The percentages of prescriptions of antibiotics for tonsillitis complying with those recommended in Antibiotic guidelines. RESULTS: In the intervention group, prescriptions consistent with recommendations in the guidelines increased from 60.5% before the campaign to 87.7% afterwards. Improvement also occurred in the control group, from 52.9% to 71.7% of prescriptions. The improvement within the intervention group was significantly greater than that within the control group. CONCLUSIONS: The educational campaign significantly improved the prescribing of appropriate antibiotics for tonsillitis by general practitioners.