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Impact of statewide program to promote appropriate antimicrobial drug use.

Belongia EA, Knobloch MJ, Kieke BA, Davis JP, Janette C, Besser RE - Emerging Infect. Dis. (2005)

Bottom Line: Prescribing by internists declined significantly more in Wisconsin than Minnesota, but the opposite was true for pediatricians.We conclude that the secular trend of declining antimicrobial drug use continued through 2003, but a large-scale educational program did not generate greater reductions in Wisconsin despite improved knowledge.State and local organizations should consider a balanced approach that includes limited statewide educational activities with increasing emphasis on local, provider-level interventions and policy development to promote careful antimicrobial drug use.

View Article: PubMed Central - PubMed

Affiliation: Marshfield Clinic Research Foundation, Marshfield, Wisconsin 54449, USA. belongia.edward@marshfieldclinic.org

ABSTRACT
The Wisconsin Antibiotic Resistance Network (WARN) was launched in 1999 to educate physicians and the public about judicious antimicrobial drug use. Public education included radio and television advertisements, posters, pamphlets, and presentations at childcare centers. Physician education included mailings, susceptibility reports, practice guidelines, satellite conferences, and presentations. We analyzed antimicrobial prescribing data for primary care physicians in Wisconsin and Minnesota (control state). Antimicrobial prescribing declined 19.8% in Minnesota and 20.4% in Wisconsin from 1998 to 2003. Prescribing by internists declined significantly more in Wisconsin than Minnesota, but the opposite was true for pediatricians. We conclude that the secular trend of declining antimicrobial drug use continued through 2003, but a large-scale educational program did not generate greater reductions in Wisconsin despite improved knowledge. State and local organizations should consider a balanced approach that includes limited statewide educational activities with increasing emphasis on local, provider-level interventions and policy development to promote careful antimicrobial drug use.

Show MeSH
Antimicrobial prescribing rate ratios by year and practice location, adjusted for specialty and baseline (1998) prescribing rate. The vertical bars show 95% confidence intervals. Ratios <1 indicate lower antimicrobial prescribing by Wisconsin physicians relative to Minnesota physicians. MSA, metropolitan statistical area.
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Figure 2: Antimicrobial prescribing rate ratios by year and practice location, adjusted for specialty and baseline (1998) prescribing rate. The vertical bars show 95% confidence intervals. Ratios <1 indicate lower antimicrobial prescribing by Wisconsin physicians relative to Minnesota physicians. MSA, metropolitan statistical area.

Mentions: Regression models were fit to compare prescribing rates in Wisconsin and Minnesota during each year from 2000 to 2003, with adjustment for specialty and baseline prescribing in 1998. Two separate models were generated. The first included physicians practicing in the Minneapolis–St. Paul metropolitan statistical area or the Milwaukee-Waukesha metropolitan statistical area. The second included physicians practicing in other counties of Minnesota or Wisconsin. In the latter model, the prescribing rate ratio was <1 in 2002 and 2003, indicating that, when the 2 largest metropolitan areas were excluded, Wisconsin physicians had significantly lower prescribing rates than those in Minnesota (Figure 2). In contrast, the prescribing rate ratio was >1 in each year within the 2 largest metropolitan areas, indicating that physicians in the Milwaukee-Waukesha MSA had higher prescribing rates than those in the Minneapolis-St. Paul MSA, after adjusting for specialty and baseline prescribing.


Impact of statewide program to promote appropriate antimicrobial drug use.

Belongia EA, Knobloch MJ, Kieke BA, Davis JP, Janette C, Besser RE - Emerging Infect. Dis. (2005)

Antimicrobial prescribing rate ratios by year and practice location, adjusted for specialty and baseline (1998) prescribing rate. The vertical bars show 95% confidence intervals. Ratios <1 indicate lower antimicrobial prescribing by Wisconsin physicians relative to Minnesota physicians. MSA, metropolitan statistical area.
© Copyright Policy
Related In: Results  -  Collection

Show All Figures
getmorefigures.php?uid=PMC3367605&req=5

Figure 2: Antimicrobial prescribing rate ratios by year and practice location, adjusted for specialty and baseline (1998) prescribing rate. The vertical bars show 95% confidence intervals. Ratios <1 indicate lower antimicrobial prescribing by Wisconsin physicians relative to Minnesota physicians. MSA, metropolitan statistical area.
Mentions: Regression models were fit to compare prescribing rates in Wisconsin and Minnesota during each year from 2000 to 2003, with adjustment for specialty and baseline prescribing in 1998. Two separate models were generated. The first included physicians practicing in the Minneapolis–St. Paul metropolitan statistical area or the Milwaukee-Waukesha metropolitan statistical area. The second included physicians practicing in other counties of Minnesota or Wisconsin. In the latter model, the prescribing rate ratio was <1 in 2002 and 2003, indicating that, when the 2 largest metropolitan areas were excluded, Wisconsin physicians had significantly lower prescribing rates than those in Minnesota (Figure 2). In contrast, the prescribing rate ratio was >1 in each year within the 2 largest metropolitan areas, indicating that physicians in the Milwaukee-Waukesha MSA had higher prescribing rates than those in the Minneapolis-St. Paul MSA, after adjusting for specialty and baseline prescribing.

Bottom Line: Prescribing by internists declined significantly more in Wisconsin than Minnesota, but the opposite was true for pediatricians.We conclude that the secular trend of declining antimicrobial drug use continued through 2003, but a large-scale educational program did not generate greater reductions in Wisconsin despite improved knowledge.State and local organizations should consider a balanced approach that includes limited statewide educational activities with increasing emphasis on local, provider-level interventions and policy development to promote careful antimicrobial drug use.

View Article: PubMed Central - PubMed

Affiliation: Marshfield Clinic Research Foundation, Marshfield, Wisconsin 54449, USA. belongia.edward@marshfieldclinic.org

ABSTRACT
The Wisconsin Antibiotic Resistance Network (WARN) was launched in 1999 to educate physicians and the public about judicious antimicrobial drug use. Public education included radio and television advertisements, posters, pamphlets, and presentations at childcare centers. Physician education included mailings, susceptibility reports, practice guidelines, satellite conferences, and presentations. We analyzed antimicrobial prescribing data for primary care physicians in Wisconsin and Minnesota (control state). Antimicrobial prescribing declined 19.8% in Minnesota and 20.4% in Wisconsin from 1998 to 2003. Prescribing by internists declined significantly more in Wisconsin than Minnesota, but the opposite was true for pediatricians. We conclude that the secular trend of declining antimicrobial drug use continued through 2003, but a large-scale educational program did not generate greater reductions in Wisconsin despite improved knowledge. State and local organizations should consider a balanced approach that includes limited statewide educational activities with increasing emphasis on local, provider-level interventions and policy development to promote careful antimicrobial drug use.

Show MeSH