Personalized prescription feedback using routinely collected data to reduce antibiotic use in primary care

Researchers at Switzerland's University Hospital Basel wondered whether feedback interventions might be a simple and inexpensive alternative to more involved and costly antibiotic stewardship initiatives. Their randomized clinical trial centered on the country's top 2,900 physician-prescribers of the drugs.

Researchers at Switzerland's University Hospital Basel wondered whether feedback interventions might be a simple and inexpensive alternative to more involved and costly antibiotic stewardship initiatives. Their randomized clinical trial centered on the country's top 2,900 physician-prescribers of the drugs. Half of the doctors were assigned to receive personalized antibiotic prescription feedback each quarter for a period of 2 years, while the other 1,450 maintained usual care. Using claims data from more than 5 million Swiss nationals, investigators found that providers receiving feedback prescribed a like amount of antibiotics to patients during both years of the study, compared with the control group. The finding indicates that implementation of a feedback intervention in a complex health care system does not reduce antibiotic use overall; however, the possibility still exists that it could influence use in specific patient populations. Fewer antibiotics were prescribed in older children, adolescents, and younger adults; but the trend was inconsistent over the 2 years, warranting further investigation.