REDUCE – prescribing feedback and decision support on antibiotic use

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Overuse of antibiotics in medical practice is contributing to the emergence of antimicrobial drug resistance.

A systematic review, updated to 2018, found that educational activities aimed at clinicians or patients, electronic decision support systems, and audit of antibiotic prescribing with feedback of results might be used to reduce unnecessary antibiotic prescribing.

However, the review concluded that it was unclear how useful these interventions might be in usual clinical practice because of a lack of information about possible adverse events, including possible increases in bacterial infections.

This trial aimed to evaluate the effectiveness and safety at population scale of electronically delivered prescribing feedback and decision support interventions at reducing antibiotic prescribing for self limiting respiratory tract infections.

The researchers found that electronically delivered interventions, integrated into practice workflow, result in moderate reductions of antibiotic prescribing for respiratory tract infections in adults, which are likely to be of importance for public health. Antibiotic prescribing to very young or old patients requires further evaluation.