Educational interventions to improve prescription and dispensing of antibiotics: A systematic review

BMC Public Health

Volumn 14, Issue 1, 2014, Pages

  Roque, Fátima ^a,b,c   Herdeiro, Maria Teresa ^b,d   Soares, Sara ^b   Rodrigues, António Teixeira ^b   Breitenfeld, Luiza ^a   Figueiras, Adolfo ^e  

^a UNIVERSITY OF BEIRA INTERIOR   (Portugal)

^b UNIVERSITY OF AVEIRO   (Portugal)

^c POLYTECHNIC INSTITUTE OF GUARDA   (Portugal)

^d INSTITUTO DE INVESTIGAÇÃO E FORMAÇÃO AVANÇADA EM CIÊNCIAS E TECNOLOGIAS DA SAÚDE   (Portugal)

^e UNIVERSITY OF SANTIAGO DE COMPOSTELA   (Spain)

Author keywords

Behavior change; Drug resistance microbial; Education medical continuing; Education pharmacy continuing; Review

Indexed keywords

ANTIINFECTIVE AGENT;

CLINICAL PRACTICE; EDUCATION; HOSPITAL; HUMAN; MEDICAL EDUCATION; PHARMACIST; PRIMARY HEALTH CARE; PROCEDURES; STANDARDS; TOTAL QUALITY MANAGEMENT;

ANTI-BACTERIAL AGENTS; EDUCATION, MEDICAL, CONTINUING; EDUCATION, PHARMACY, CONTINUING; HOSPITALS; HUMANS; PHARMACISTS; PRACTICE PATTERNS, PHYSICIANS'; PRIMARY HEALTH CARE; QUALITY IMPROVEMENT;

EID: 84924289037     PISSN: None     EISSN: 14712458     Source Type: Journal    
DOI: 10.1186/1471-2458-14-1276     Document Type: Article

References (109)

1. Spellberg B, Powers JH, Brass EP, Miller LG, Edwards JE: Trends in antimicrobial drug development: implications for the future. Clinical Infectious Diseases 2004, 38(9):1279-1286.
2. ECDC EMA: Technical Report-The Bacterial Chalange: time to react. Stockholm: 2009. on line in http://www.ecdc.europa.eu/en/publications/Publications/0909-TER-The-Bacterial-Challenge-Time-to-React.pdf
3. Deuster S, Roten I, Muehlebach S: Implementation of treatment guidelines to support judicious use of antibiotic therapy. Journal of Clinical Pharmacy and Therapeutics 2010, 35(1):71-78.
4. Goossens H, Ferech M, Vander Stichele R, Elseviers M: Outpatient antibiotic use in Europe and association with resistance: a cross-national database study.The Lancet 2005, 365(9459):579-587.
5. van de Sande-Bruinsma N, Grundmann H, Verloo D, Tiemersma E, Monen J, Goossens H, Ferech M, System EARS: Antimicrobial drug use and resistance in Europe. Emerging infectious diseases 2008, 14(11):1722.
6. Grigoryan L, Burgerhof JGM, Degener JE, Deschepper R, Lundborg CS, Monnet DL, Scicluna EA, Birkin J, Haaijer-Ruskamp FM: Determinants of self-medication with antibiotics in Europe: the impact of beliefs, country wealth and the healthcare system. Journal of Antimicrobial Chemotherapy 2008, 61(5):1172-1179.
7. Grigoryan L, Burgerhof JGM, Haaijer-Ruskamp FM, Degener JE, Deschepper R, Monnet DL, Di Matteo A, Scicluna EA, Bara A-C, Lundborg CS, Barkin J, SAR group: Is self-medication with antibiotics in Europe driven by prescribed use? Journal of Antimicrobial Chemotherapy 2007, 59(1):152-156.
8. Deschepper R, Grigoryan L, Lundborg C, Hofstede G, Cohen J, Kelen G, Deliens L, Haaijer-Ruskamp F: Are cultural dimensions relevant for explaining cross-national differences in antibiotic use in Europe? BMC Health Services Research 2008, 8(1):123.
9. Steinman MA, Ranji SR, Shojania KG, Gonzales R: Improving Antibiotic Selection: A Systematic Review and Quantitative Analysis of Quality Improvement Strategies. Medical Care 2006, 44(7):617-628. 610.1097/1001. mlr.0000215846.0000225591.0000215822.
10. Boonacker CWB, Hoes AW, Dikhoff M-J, Schilder AGM, Rovers MM: Interventions in health care professionals to improve treatment in children with upper respiratory tract infections. International journal of pediatric otorhinolaryngology 2010, 74(10):1113-1121.
11. Kaki R, Elligsen M, Walker S, Simor A, Palmay L, Daneman N: Impact of antimicrobial stewardship in critical care: a systematic review. Journal of Antimicrobial Chemotherapy 2011, 66(6):1223-1230.
12. Charani E, Edwards R, Sevdalis N, Alexandrou B, Sibley E, Mullett D, Franklin BD, Holmes A: Behavior Change Strategies to Influence Antimicrobial Prescribing in Acute Care: A Systematic Review. Clinical Infectious Diseases 2011, 53(7):651-662.
13. van der Velden AW, Pijpers EJ, Kuyvenhoven MM, Tonkin-Crine SK, Little P, Verheij TJ: Effectiveness of physician-targeted interventions to improve antibiotic use for respiratory tract infections.The British journal of general practice: the journal of the Royal College of General Practitioners 2012, 62(605):e801-e807.
14. Ranji SR, Steinman MA, Shojania KG, Sundaram V, Lewis R, Arnold S, Gonzales R: Closing the quality gap: a critical analysis of quality improvement strategies (vol. 4: antibiotic prescribing behavior). 2006.
15. Arnold SR, Straus SE, Arnold S: Interventions to improve antibiotic prescribing practices in ambulatory care. Cochrane Database Syst Rev 2005, 4(4):CD003539.
16. Davey P, Brown E, Fenelon L, Finch R, Gould I, Hartman G, Holmes A, Ramsay C, Taylor E, Wilcox M: Interventions to improve antibiotic prescribing practices for hospital inpatients (Review). 2007.
17. Lopez-Vazquez P, Vazquez-Lago JM, Figueiras A: Misprescription of antibiotics in primary care: a critical systematic review of its determinants. Journal of Evaluation in Clinical Practice 2012, 18(2):473-484.
18. Figueiras A, Sastre I, Gestal-Otero JJ: Effectiveness of educational interventions on the improvement of drug prescription in primary care: a critical literature review. Journal of Evaluation in Clinical Practice 2001, 7(2):223-241.
19. Davis DA, Thomson M, Oxman AD, Haynes R: Changing physician performance: A systematic review of the effect of continuing medical education strategies. JAMA 1995, 274(9):700-705.
20. Dollman WB, LeBlanc VT, Stevens L, O'Connor PJ, Turnidge JD: A community-based intervention to reduce antibiotic use for upper respiratory tract infections in regional South Australia. Medical journal of Australia 2005, 182(12):617-620.
21. Hrisos S, Eccles M, Johnston M, Francis J, Kaner E, Steen N, Grimshaw J: An intervention modelling experiment to change GPs' intentions to implement evidence-based practice: using theory-based interventions to promote GP management of upper respiratory tract infection without prescribing antibiotics #2. BMC Health Services Research 2008, 8(1):10.
22. Hennessy TW, Petersen KM, Bruden D, Parkinson AJ, Hurlburt D, Getty M, Schwartz B, Butler JC: Changes in Antibiotic-Prescribing Practices and Carriage of Penicillin-Resistant Streptococcus pneumoniae: A Controlled Intervention Trial in Rural Alaska. Clinical Infectious Diseases 2002, 34(12):1543-1550.
23. Rubin MA, Bateman K, Alder S, Donnelly S, Stoddard GJ, Samore MH: A Multifaceted Intervention to Improve Antimicrobial Prescribing for Upper Respiratory Tract Infections in a Small Rural Community. Clinical Infectious Diseases 2005, 40(4):546-553.
24. Naughton C, Feely J, Bennett K: A RCT evaluating the effectiveness and cost-effectiveness of academic detailing versus postal prescribing feedback in changing GP antibiotic prescribing. Journal of Evaluation in Clinical Practice 2009, 15(5):807-812.
25. Chazan B, Turjeman RBZ, Frost Y, Besharat B, Tabenkin H, Stainberg A, Sakran W, Raz R: Antibiotic consumption successfully reduced by a community intervention program. IMAJ-RAMAT GAN-2007, 9(1):16.
26. Briel M, Christ-Crain M, Young J, Schuetz P, Huber P, Periat P, Bucher H, Muller B: Procalcitonin-guided antibiotic use versus a standard approach for acute respiratory tract infections in primary care: study protocol for a randomised controlled trial and baseline characteristics of participating general practitioners [ISRCTN73182671]. BMC Family Practice 2005, 6(1):34.
27. Monette J, Miller MA, Monette M, Laurier C, Boivin J-F, Sourial N, Le Cruguel J-P, Vandal A, Cotton-Montpetit M: Effect of an Educational Intervention on Optimizing Antibiotic Prescribing in Long-Term Care Facilities. Journal of the American Geriatrics Society 2007, 55(8):1231-1235.
28. Enriquez-Puga A, Baker R, Paul S, Villoro-Valdes R: Effect of educational outreach on general practice prescribing of antibiotics and antidepressants: A two-year randomised controlled trial. Scandinavian Journal of Primary Health Care 2009, 27(4):195-201.
29. Bjerrum L, Cots J, Llor C, Molist N, Munck A: Effect of intervention promoting a reduction in antibiotic prescribing by improvement of diagnostic procedures: a prospective, before and after study in general practice. Eur J Clin Pharmacol 2006, 62(11):913-918.
30. Mcisaac WJ, Goel V, To T, Permaul JA, Low DE: Effect on antibiotic prescribing of repeated clinical prompts to use a sore throat score. Journal of family practice 2002, 51(4):339-344.
31. Wheeler JG, Fair M, Simpson PM, Rowlands LA, Aitken ME, Jacobs RF: Impact of a Waiting Room Videotape Message on Parent Attitudes Toward Pediatric Antibiotic Use. Pediatrics 2001, 108(3):591-596.
32. Juzych NS, Banerjee M, Essenmacher L, Lerner S: Improvements in antimicrobial prescribing for treatment of upper respiratory tract infections through provider education. J GEN INTERN MED 2005, 20(10):901-905.
33. Smeets HM, Kuyvenhoven MM, Akkerman AE, Welschen I, Schouten GP, van Essen GA, Verheij TJM: Intervention with educational outreach at large scale to reduce antibiotics for respiratory tract infections: a controlled before and after study. Family Practice 2009, 26(3):183-187.
34. Mandryk JA, Mackson JM, Horn FE, Wutzke SE, Badcock C-A, Hyndman RJ, Weekes LM: Measuring change in prescription drug utilization in Australia. Pharmacoepidemiology and Drug Safety 2006, 15(7):477-484.
35. Stille CJ, Rifas-Shiman SL, Kleinman K, Kotch JB, Finkelstein JA: Physician Responses to a Community-Level Trial Promoting Judicious Antibiotic Use.The Annals of Family Medicine 2008, 6(3):206-212.
36. Finkelstein JA, Davis RL, Dowell SF, Metlay JP, Soumerai SB, Rifas-Shiman SL, Higham M, Miller Z, Miroshnik I, Pedan A, Platt R: Reducing Antibiotic Use in Children: A Randomized Trial in 12 Practices. Pediatrics 2001, 108(1):1-7.
37. Altiner A, Brockmann S, Sielk M, Wilm S, Wegscheider K, Abholz H-H: Reducing antibiotic prescriptions for acute cough by motivating GPs to change their attitudes to communication and empowering patients: a cluster-randomized intervention study. Journal of Antimicrobial Chemotherapy 2007, 60(3):638-644.
38. Légaré F, Labrecque M, LeBlanc A, Njoya M, Laurier C, Côté L, Godin G, Thivierge RL, O'Connor A, St-Jacques S: Training family physicians in shared decision making for the use of antibiotics for acute respiratory infections: a pilot clustered randomized controlled trial. Health Expectations 2011, 14:96-110.
39. Kiang KM, Kieke BA, Como-Sabetti K, Lynfield R, Besser RE, Belongia EA: Clinician knowledge and beliefs after statewide program to promote appropriate antimicrobial drug use. Emerg Infect Dis 2005, 11(6):904-911.
40. Mohagheghi MA, Mosavi-Jarrahi A, Khatemi-Moghaddam M, Afhami S, Khodai S, Azemoodeh O: Community-based outpatient practice of antibiotics use in Tehran. Pharmacoepidemiology and Drug Safety 2005, 14(2):135-138.
41. Irurzun C, González M, Recondo M, Urtasun M: Efectividad de la aplicación de un protocolo clínico para el manejo de la faringitis aguda en adultos. TITLEREVISTA 2005, 35(01):22-29.
42. Chalker J, Ratanawijitrasin S, Chuc NTK, Petzold M, Tomson G: Effectiveness of a multi-component intervention on dispensing practices at private pharmacies in Vietnam and Thailand-a randomized controlled trial. Social Science & Medicine 2005, 60(1):131-141.
43. Finkelstein JA, Huang SS, Kleinman K, Rifas-Shiman SL, Stille CJ, Daniel J, Schiff N, Steingard R, Soumerai SB, Ross-Degnan D, Goldman D, Platt R: Impact of a 16-Community Trial to Promote Judicious Antibiotic Use in Massachusetts. Pediatrics 2008, 121(1):e15-e23.
44. Chuc NTK, Larsson M, Do NT, Diwan VK, Tomson GB, Falkenberg T: Improving private pharmacy practice: A multi-intervention experiment in Hanoi, Vietnam. Journal of clinical epidemiology 2002, 55(11):1148-1155.
45. Belongia EA, Sullivan BJ, Chyou P-H, Madagame E, Reed KD, Schwartz B: A Community Intervention Trial to Promote Judicious Antibiotic Use and Reduce Penicillin-Resistant Streptococcus pneumoniae Carriage in Children. Pediatrics 2001, 108(3):575-583.
46. Belongia EA, Knobloch MJ, Kieke BA, Davis JP, Janette C, Besser RE: Impact of statewide program to promote appropriate antimicrobial drug use. Emerg Infect Dis 2005, 11(6):912-920.
47. Greene RA, Beckman H, Chamberlain J, Partridge G, Miller M, Burden D, Kerr J: Increasing adherence to a community-based guideline for acute sinusitis through education, physician profiling, and financial incentives.The American journal of managed care 2004, 10(10):670-678.
48. Teng CL, Achike FI, Phua KL, Nurjahan MI, Mastura I, Asiah HN, Mariam AM, Narayanan S, Norsiah A, Sabariah I: Modifying antibiotic prescribing: the effectiveness of academic detailing plus information leaflet in a Malaysian primary care setting.The Medical journal of Malaysia 2006, 61(3):323-331.
49. Awad AI, Eltayeb IB, Baraka OZ: Changing antibiotics prescribing practices in health centers of Khartoum State. Sudan. Eur J Clin Pharmacol 2006, 62(2):135-142.
50. Welschen I, Kuyvenhoven MM, Hoes AW, Verheij TJM: Effectiveness of a multiple intervention to reduce antibiotic prescribing for respiratory tract symptoms in primary care: randomised controlled trial. BMJ 2004. 329:431
51. Gonzales R, Sauaia A, Corbett KK, Maselli JH, Erbacher K, Leeman-castillo BA, Darr CA, Houck PM: Antibiotic Treatment of Acute Respiratory Tract Infections in the Elderly: Effect of a Multidimensional Educational Intervention. Journal of the American Geriatrics Society 2004, 52(1):39-45.
52. Colomina Rodríguez J, Domínguez Márquez V, Gimeno Vilarrasa F, Sarrió Montes G, Guerrero Espejo A: Impacto de un modelo integrado para el uso racional de antimicrobianos (Proyecto Miura) en un área de salud. Revista Española de Salud Pública 2010, 84:281-291.
53. Hickman DE, Stebbins MR, Hanak JR, Guglielmo BJ: Pharmacy-Based Intervention to Reduce Antibiotic Use for Acute Bronchitis. Annals of Pharmacotherapy 2003, 37(2):187-191.
54. Coenen S, Van Royen P, Michiels B, Denekens J: Optimizing antibiotic prescribing for acute cough in general practice: a cluster-randomized controlled trial. Journal of Antimicrobial Chemotherapy 2004, 54(3):661-672.
55. Perz JF, Craig AS, Coffey CS, Jorgensen DM, Mitchel E, Hall S, Schaffner W, Griffin MR: CHanges in antibiotic prescribing for children after a communitywide campaign. JAMA 2002, 287(23):3103-3109.
56. Søndergaard J, Andersen M, Støvring H, Kragstrup J: Mailed prescriber feedback in addition to a clinical guideline has no impact: a randomised, controlled trial. Scandinavian Journal of Primary Health Care 2003, 21(1):47-51.
57. Doyne EO, Alfaro M, Siegel RM, Atherton HD, Schoettker PJ, Bernier J, Kotagal UR: A randomized controlled trial to change antibiotic prescribing patterns in a community. Archives of Pediatrics & Adolescent Medicine 2004, 158(6):577-583.
58. Bauchner H, Marchant CD, Bisbee A, Heeren T, Wang B, McCabe M, Pelton S, Group B-BPR: Effectiveness of Centers for Disease Control and Prevention Recommendations for Outcomes of Acute Otitis Media. Pediatrics 2006, 117(4):1009-1017.
59. Christakis DA, Zimmerman FJ, Wright JA, Garrison MM, Rivara FP, Davis RL: A Randomized Controlled Trial of Point-of-Care Evidence to Improve the Antibiotic Prescribing Practices for Otitis Media in Children. Pediatrics 2001, 107(2):e15.
60. Småbrekke L, Berild D, Giaever A, Myrbakk T, Fuskevåg A, Ericson JU, Flaegstad T, Olsvik Ø, Ringertz SH: Educational Intervention for Parents and Healthcare Providers Leads to Reduced Antibiotic Use in Acute Otitis Media. Scandinavian Journal of Infectious Diseases 2002, 34(9):657-659.
61. Bjerrum L, Munck A, Gahrn-Hansen B, Hansen M, Jarbol D, Cordoba G, Llor C, Cots J, Hernandez S, Lopez-Valcarcel B, Perez A, Caballero L, von der Heyde W, Radzevicience R, Jurgutis A, Reutskiy A, Egorova E, Strandberg EL, Ovhed I, Molstad S, Stichele RV, Benko R, Vlahovic-Palcevski V, Lionis C, Ronning M: Health Alliance for prudent antibiotic prescribing in patients with respiratory tract infections (HAPPY AUDIT)-impact of a non-randomised multifaceted intervention programme. BMC Family Practice 2011, 12(1):52.
62. Regev-Yochay G, Raz M, Dagan R, Roizin H, Morag B, Hetman S, Ringel S, Ben-Israel N, Varon M, Somekh E, Rubinstein E: Reduction in Antibiotic Use Following a Cluster Randomized Controlled Multifaceted Intervention: The Israeli Judicious Antibiotic Prescription Study. Clinical Infectious Diseases 2011, 53(1):33-41.
63. Llor C, Cots JM, González López-Valcárcel B, Alcántara JD, García G, Arranz J, Monedero MJ, Ortega J, Pineda V, Guerra G, Gómez M, Hernández S, Paredes J, Cid M, Pérez C: Effect of two interventions on reducing antibiotic prescription in pharyngitis in primary care. Journal of Antimicrobial Chemotherapy 2011, 66(1):210-215.
64. Weiss K, Blais R, Fortin A, Lantin S, Gaudet M: Impact of a Multipronged Education Strategy on Antibiotic Prescribing in Quebec. Canada. Clinical Infectious Diseases 2011, 53(5):433-439.
65. Llor C, Madurell J, Balagué-Corbella M, Gómez M, Cots JM: Impact on antibiotic prescription of rapid antigen detection testing in acute pharyngitis in adults: a randomised clinical trial. British Journal of General Practice 2011, 61(586):e244-e251.
66. McKay RM, Vrbova L, Fuertes E, Chong M, David S, Dreher K, Purych D, Blondel-Hill E, Henry B, Marra F, Kendall PR, Patrick DM: Evaluation of the Do Bugs Need Drugs? program in British Columbia: Can we curb antibiotic prescribing? Canadian Journal of Infectious Diseases & Medical Microbiology 2011, 22(1):19-24.
67. Chang MT, Wu TH, Wang CY, Jang TN, Huang CY: The impact of an intensive antimicrobial control program in a Taiwanese medical center. Pharm World Sci 2006, 28(4):257-264.
68. Naughton BJ, Mylotte JM, Ramadan F, Karuza J, Priore RL: Antibiotic Use, Hospital Admissions, and Mortality Before and After Implementing Guidelines for Nursing Home-Acquired Pneumonia. Journal of the American Geriatrics Society 2001, 49(8):1020-1024.
69. Lutters M, Harbarth S, Janssens J-P, Freudiger H, Herrmann F, Michel J-P, Vogt N: Effect of a Comprehensive, Multidisciplinary, Educational Program on the Use of Antibiotics in a Geriatric University Hospital. Journal of the American Geriatrics Society 2004, 52(1):112-116.
70. Loeb M, Brazil K, Lohfeld L, McGeer A, Simor A, Stevenson K, Zoutman D, Smith S, Liu X, Walter SD: Effect of a multifaceted intervention on number of antimicrobial prescriptions for suspected urinary tract infections in residents of nursing homes: cluster randomised controlled trial. BMJ 2005, 331(7518):669.
71. Lesprit P, Duong T, Girou E, Hemery F, Brun-Buisson C: Impact of a computer-generated alert system prompting review of antibiotic use in hospitals. Journal of Antimicrobial Chemotherapy 2009, 63(5):1058-1063.
72. Akter SFU, Heller RD, Smith AJ, Milly AF: Impact of a training intervention on use of antimicrobials in teaching hospitals.The Journal of Infection in Developing Countries 2009, 3(06):447-451.
73. Paul M, Andreassen S, Tacconelli E, Nielsen AD, Almanasreh N, Frank U, Cauda R, Leibovici L, Group obotTS: Improving empirical antibiotic treatment using TREAT, a computerized decision support system: cluster randomized trial. Journal of Antimicrobial Chemotherapy 2006, 58(6):1238-1245.
74. Camins BC, King MD, Wells JB, Googe HL, Patel M, Kourbatova EV, Blumberg HM: Impact of an Antimicrobial Utilization Program on Antimicrobial Use at a Large Teaching Hospital: A Randomized Controlled Trial. Infection Control and Hospital Epidemiology 2009, 30(10):931-938.
75. Westphal JF, Jehl F, Javelot H, Nonnenmacher C: Enhanced physician adherence to antibiotic use guidelines through increased availability of guidelines at the time of drug ordering in hospital setting.Pharmacoepidemiology and Drug Safety 2011, 20(2):162-168.
76. Mullett CJ, Evans RS, Christenson JC, Dean JM: Development and Impact of a Computerized Pediatric Antiinfective Decision Support Program. Pediatrics 2001, 108(4):e75.
77. von Gunten V, Reymond J-P, Beney J: Clinical and economic outcomes of pharmaceutical services related to antibiotic use: a literature review.Pharmacy World & Science 2007, 29(3):146-163.
78. Ansari F, Gray K, Nathwani D, Phillips G, Ogston S, Ramsay C, Davey P: Outcomes of an intervention to improve hospital antibiotic prescribing: interrupted time series with segmented regression analysis. Journal of Antimicrobial Chemotherapy 2003, 52(5):842-848.
79. Kisuule F, Wright S, Barreto J, Zenilman J: Improving antibiotic utilization among hospitalists: A pilot academic detailing project with a public health approach. Journal of Hospital Medicine 2008, 3(1):64-70.
80. Halm EA, Horowitz C, Silver A, Fein A, Dlugacz YD, Hirsch B, Chassin MR: LImited impact of a multicenter intervention to improve the quality and efficiency of pneumonia care. CHEST Journal 2004, 126(1):100-107.
81. López-Medrano F, San Juan R, Serrano O, Chaves F, Lumbreras C, Lizasoaín M, Herreros de Tejada A, Aguado JM: PACTA: efecto de un programa no impositivo de control y asesoramiento del tratamiento antibiótico sobre la disminución de los costes y el descenso de ciertas infecciones nosocomiales. TITLEREVISTA 2005, 23(04):186-190.
82. Agwu AL, Lee CKK, Jain SK, Murray KL, Topolski J, Miller RE, Townsend T, Lehmann CU: A World Wide Web-Based Antimicrobial Stewardship Program Improves Efficiency, Communication, and User Satisfaction and Reduces Cost in a Tertiary Care Pediatric Medical Center. Clinical Infectious Diseases 2008, 47(6):747-753.
83. Barenfanger J, Short MA, Groesch AA: Improved Antimicrobial Interventions Have Benefits. Journal of Clinical Microbiology 2001, 39(8):2823-2828.
84. Rüttimann S, Keck B, Hartmeier C, Maetzel A, Bucher HC: Long-Term Antibiotic Cost Savings from a Comprehensive Intervention Program in a Medical Department of a University-Affiliated Teaching Hospital. Clinical Infectious Diseases 2004, 38(3):348-356.
85. Martin C, Ofotokun I, Rapp R, Empey K, Armitstead J, Pomeroy C, Hoven A, Evans M: Results of an antimicrobial control program at a university hospital. American Journal of Health-System Pharmacy 2005, 62(7):732-738.
86. Solomon DH, Van Houten L, Glynn RJ, Baden L, Curtis K, Schrager H, Avorn J: Academic detailing to improve use of broad-spectrum antibiotics at an academic medical center. Archives of Internal Medicine 2001, 161(15):1897-1902.
87. Fowler S, Webber A, Cooper BS, Phimister A, Price K, Carter Y, Kibbler CC, Simpson AJH, Stone SP: Successful use of feedback to improve antibiotic prescribing and reduce Clostridium difficile infection: a controlled interrupted time series. Journal of Antimicrobial Chemotherapy 2007, 59(5):990-995.
88. Sintchenko V, Iredell JR, Gilbert GL, Coiera E: Handheld Computer-based Decision Support Reduces Patient Length of Stay and Antibiotic Prescribing in Critical Care. Journal of the American Medical Informatics Association 2005, 12(4):398-402.
89. Yong MK, Buising KL, Cheng AC, Thursky KA: Improved susceptibility of Gram-negative bacteria in an intensive care unit following implementation of a computerized antibiotic decision support system. Journal of Antimicrobial Chemotherapy 2010, 65(5):1062-1069.
90. Meyer E, Schwab F, Pollitt A, Bettolo W, Schroeren-Boersch B, Trautmann M: Impact of a Change in Antibiotic Prophylaxis on Total Antibiotic Use in a Surgical Intensive Care Unit. Infection 2010, 38(1):19-24.
91. Thursky KA, Buising KL, Bak N, Macgregor L, Street AC, Macintyre CR, Presneill JJ, Cade JF, Brown GV: Reduction of broad-spectrum antibiotic use with computerized decision support in an intensive care unit. International Journal for Quality in Health Care 2006, 18(3):224-231.
92. Pettersson E, Vernby Å, Mölstad S, Lundborg CS: Can a multifaceted educational intervention targeting both nurses and physicians change the prescribing of antibiotics to nursing home residents? A cluster randomized controlled trial. Journal of Antimicrobial Chemotherapy 2011, 66(11):2659-2666.
93. Tängdén T, Eriksson B-M, Melhus Å, Svennblad B, Cars O: Radical reduction of cephalosporin use at a tertiary hospital after educational antibiotic intervention during an outbreak of extended-spectrum β-lactamaseproducing Klebsiella pneumoniae. Journal of Antimicrobial Chemotherapy 2011, 66(5):1161-1167.
94. Talpaert MJ, Gopal Rao G, Cooper BS, Wade P: Impact of guidelines and enhanced antibiotic stewardship on reducing broad-spectrum antibiotic usage and its effect on incidence of Clostridium difficile infection. Journal of Antimicrobial Chemotherapy 2011, 66(9):2168-2174.
95. Bevilacqua S, Demoré B, Erpelding M-L, Boschetti E, May T, May I, Rabaud C, Thilly N: Effects of an operational multidisciplinary team on hospital antibiotic use and cost in France: a cluster controlled trial. Int J Clin Pharm 2011, 33(3):521-528.
96. Shen J, Sun Q, Zhou X, Wei Y, Qi Y, Zhu J, Yan T: Pharmacist interventions on antibiotic use in inpatients with respiratory tract infections in a Chinese hospital. Int J Clin Pharm 2011, 33(6):929-933.
97. Tonkin-Crine S, Yardley L, Little P: Antibiotic prescribing for acute respiratory tract infections in primary care: a systematic review and meta-ethnography. Journal of Antimicrobial Chemotherapy 2011, 66(10):2215-2223.
98. Llor C, Cots JM: The Sale of Antibiotics without Prescription in Pharmacies in Catalonia. Spain. Clinical Infectious Diseases 2009, 48(10):1345-1349.
99. Apisarnthanarak A, Mundy LM: Comparison of Methods of Measuring Pharmacy Sales of Antibiotics without Prescriptions in Pratumthani, Thailand. Infection Control and Hospital Epidemiology 2009, 30(11):1130-1132.
100. Plachouras D, Kavatha D, Antoniadou A, Giannitsioti E, Poulakou G, Kanellakopoulou K, Giamarellou H: Dispensing of antibiotics without prescription in Greece, 2008: another link in the antibiotic resistance chain. Euro Surveill 2010, 15(7):19488.
101. Llor C, Monnet D, Cots J: Small pharmacies are more likely to dispense antibiotics without a medical prescription than large pharmacies in Catalonia. Spain. Euro Surveill 2010, 15:32.
102. Volpato DE, Souza BV, Dalla Rosa LG, Melo LH, Daudt CAS, Deboni L: Use of antibiotics without medical prescription. Brazilian Journal of Infectious Diseases 2005, 9:288-291.
103. Cars O, Mölstad S, Melander A: Variation in antibiotic use in the European Union.The Lancet 2001, 357(9271):1851-1853.
104. Gross R, Morgan AS, Kinky DE, Weiner M, Gibson GA, Fishman NO: Impact of a Hospital-Based Antimicrobial Management Program on Clinical and Economic Outcomes. Clinical Infectious Diseases 2001, 33(3):289-295.
105. O'Brien MA, Rogers S, Jamtvedt G, Oxman AD, Odgaard-Jensen J, Kristoffersen DT, Forsetlund L, Bainbridge D, Freemantle N, Davis D: Educational outreach visits: effects on professional practice and health care outcomes. Cochrane database syst rev 2007, 4(4)CD000172.
106. Forsetlund L, Bjorndal A, Rashidian A, Jamtvedt G, O'Brien MA, Wolf F, Davis D, Odgaard-Jensen J, Oxman AD: Continuing education meetings and workshops: effects on professional practice and health care outcomes. Cochrane Database Syst Rev 2009, 2, CD003030.
107. Davis D, O'Brien M, Freemantle N, Wolf FM, Mazmanian P, Taylor-Vaisey A: Impact of formal continuing medical education: Do conferences, workshops, rounds, and other traditional continuing education activities change physician behavior or health care outcomes? JAMA 1999, 282(9):867-874.
108. Figueiras A, Sastre I, Tato F, Rodríguez C, Lado E, Caamaño F, Gestal-Otero JJ: One-to-One Versus Group Sessions to Improve Prescription in Primary Care: A Pragmatic Randomized Controlled Trial. Medical Care 2001, 39(2):158-167.
109. Ribeiro-Vaz I, Herdeiro MT, Polónia J, Figueiras A: Estratégias para aumentar a sensibilidade da farmacovigilância em Portugal. Revista de Saúde Pública 2011, 45:129-135.