Evaluation and improvement of antibiotic prescription quality in acute uncomplicated cystitis in primary care facilities in Lisbon
DOI:
https://doi.org/10.32385/rpmgf.v41i3.14141Keywords:
Cystitis, Practice patterns, Physicians’, Drug resistance, Bacterial, Primary health care, Antimicrobial stewardship, Continuing medical educationAbstract
Introduction: Urinary tract infections are one of the main causes of antibiotic prescriptions in primary healthcare. An audit on the quality of antibiotic prescriptions for uncomplicated acute cystitis in a group of health centers in Lisbon showed an overall compliance rate of 35.81%. In response to this result, a quality improvement initiative was developed. Objective: To improve the quality of antibiotic prescriptions for uncomplicated acute cystitis, assess the effectiveness of the intervention, and evaluate overall prescription compliance. Methods: The intervention consisted of educational sessions, auditing and feedback, creating a flowchart to support prescriptions, and distributing a leaflet to patients. A quasi-experimental study was designed to assess the results of the intervention, comparing overall and unit-specific compliance before and after the intervention. Results: One thousand two hundred and twenty-six episodes were analyzed in the pre-intervention period and 1,055 episodes in the post-intervention period. After the intervention, overall compliance was 65.31%, representing an overall prescription improvement of 82.40%. The improvement was considered significant. Conclusion: The authors believe that the combination of several strategies was crucial to the success of the results achieved. Additionally, the large number of episodes analyzed reinforces the robustness of these results. It is essential to regularly reassess the quality of prescription practices to ensure the long-term sustainability of improvements. Future efforts, which, in addition to auditing the adequacy of antibiotic prescriptions, aim to investigate the determinants and beliefs related to prescription practices, may help design more tailored interventions that cost-effectively ensure effective and long-lasting results.
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