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Article

Impact of a Social Marketing Intervention on General Practitioners’ Antibiotic Prescribing Practices for Acute Respiratory Tract Complaints in Malta

1
Department of Global Public Health, Health Systems and Policy: Improving Use of Medicines, Karolinska Institutet, 171 77 Stockholm, Sweden
2
Center for Molecular Medicine at BioClinicum, Cardiovascular Medicine Unit, Department of Medicine, Karolinska Institutet, Karolinska University Hospital Solna, 171 76 Stockholm, Sweden
3
Division of Cardiovascular Medicine, Stanford University School of Medicine, Palo Alto, CA 94305, USA
4
Department of Infection Prevention and Control, Mater Dei Hospital, MSD 2090 Msida, Malta
5
Faculty of Medicine and Surgery, University of Malta, MSD 2090 Msida, Malta
6
Division of Primary Care and Population Health, Stanford University School of Medicine, Stanford, CA 94305, USA
*
Author to whom correspondence should be addressed.
These authors contributed equally to this work.
Academic Editor: Akke Vellinga
Received: 15 February 2021 / Revised: 25 March 2021 / Accepted: 26 March 2021 / Published: 31 March 2021
(This article belongs to the Special Issue Antibiotic Use in the Communities)
Introduction: Antibiotics are commonly prescribed in primary care for acute respiratory tract complaints (aRTCs), often inappropriately. Social marketing interventions could improve prescribing in such settings. We evaluate the impact of a social marketing intervention on general practitioners’ (GPs’) antibiotic prescribing for aRTCs in Malta. Methods: Changes in GPs’ antibiotic prescribing were monitored over two surveillance periods between 2015 and 2018. Primary outcome: change in antibiotic prescription for aRTCs. Secondary outcomes: change in antibiotic prescription: (i) for immediate use, (ii) for delayed antibiotic prescription, (iii) by diagnosis, and (iv) by antibiotic class. Data were analysed using clustered analysis and interrupted time series analysis (ITSA). Results: Of 33 participating GPs, 18 successfully completed the study. Although clustered analyses showed a significant 3% decrease in overall antibiotic prescription (p = 0.024), ITSA showed no significant change overall (p = 0.264). Antibiotic prescription decreased significantly for the common cold (p < 0.001), otitis media (p = 0.044), and sinusitis (p = 0.004), but increased for pharyngitis (p = 0.015). Conclusions: The intervention resulted in modest improvements in GPs’ antibiotic prescribing. A more top-down approach will likely be required for future initiatives to be successful in this setting, focusing on diagnostic and prescribing support like rapid diagnostic testing, prescribing guidelines, and standardised delayed antibiotic prescriptions. View Full-Text
Keywords: antibiotics; antibiotic use; behaviour change; surveillance; primary care; general practitioners; respiratory tract infections; culture; Malta antibiotics; antibiotic use; behaviour change; surveillance; primary care; general practitioners; respiratory tract infections; culture; Malta
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MDPI and ACS Style

Machowska, A.; Marrone, G.; Saliba-Gustafsson, P.; Borg, M.A.; Saliba-Gustafsson, E.A.; Stålsby Lundborg, C. Impact of a Social Marketing Intervention on General Practitioners’ Antibiotic Prescribing Practices for Acute Respiratory Tract Complaints in Malta. Antibiotics 2021, 10, 371. https://0-doi-org.brum.beds.ac.uk/10.3390/antibiotics10040371

AMA Style

Machowska A, Marrone G, Saliba-Gustafsson P, Borg MA, Saliba-Gustafsson EA, Stålsby Lundborg C. Impact of a Social Marketing Intervention on General Practitioners’ Antibiotic Prescribing Practices for Acute Respiratory Tract Complaints in Malta. Antibiotics. 2021; 10(4):371. https://0-doi-org.brum.beds.ac.uk/10.3390/antibiotics10040371

Chicago/Turabian Style

Machowska, Anna, Gaetano Marrone, Peter Saliba-Gustafsson, Michael A. Borg, Erika A. Saliba-Gustafsson, and Cecilia Stålsby Lundborg. 2021. "Impact of a Social Marketing Intervention on General Practitioners’ Antibiotic Prescribing Practices for Acute Respiratory Tract Complaints in Malta" Antibiotics 10, no. 4: 371. https://0-doi-org.brum.beds.ac.uk/10.3390/antibiotics10040371

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