What’s the best way to get doctors to stop giving antibiotics to patients who don’t need them?

A study suggests telling them to stop is an important step in the right direction.

The study, published on Feb. 9 in the Journal of the American Medical Association, found that physicians who are subject to an intervention about the dangers of unnecessary antibiotic prescriptions changed their prescription practices dramatically as a result.

The study focused specifically on how physicians deal with patients citing four common conditions that do not require antibiotics: “nonspecific upper respiratory tract infections, acute bronchitis, and influenza.”

The team of researchers, led by Professor Daniella Meeker of UCLA, observed 248 primary care physicians for 18 months before the intervention and 18 months after.

While all of the doctors were provided information about antibiotic prescribing, others were subjected to additional interventions.

For one group, the electronic health record system would suggest an alternative to antibiotics any time a physician sought to prescribe antibiotics.

Another group was instructed to give a written justification for every antibiotics prescription, while the third group was subjected to emails comparing their prescription rates to that of their peers.

At the end of the three -ear period, every group had decreased its prescription rate. Specifically:

  • Those who had not been subjected to additional interventions decreased their rate from 24.1 percent to 13 percent.

  • Those who were also subjected to the first intervention (suggested alternatives from the EHR), decreased their prescription rate 22.1 percent to 6.1 percent.

  • The rate for those who had to justify their prescriptions dropped from 23.2 percent to 5.2 percent.

  • For those whose prescription rates were compared to their peers, the rate dropped from 19.9 percent to 3.7 percent.

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