摘要：A randomised controlled trial involving 54 general practitioners (GPs) was conducted in Canberra,Australian Capital Territory from September 1997 to November 1999. In the first year of the study, 24 GPs, who constituted the active arm of the intervention group, were involved in the considerationof evidence and the development and implementation of a set of clinical guidelines for the treatmentof acute respiratory infections. These guidelines were then endorsed in a meeting together withspecialist colleagues. In the second year of the study the group of GPs who had been acting ascontrols, received a moderate intervention consisting of a brief educational event and distribution ofthe locally developed guidelines. We obtained data from January 1997 to December 1999 from theHealth Insurance Commission on prescribing rates for 40 of the doctors in the study. The rate ofprescribing was calculated as the number of antibiotic prescriptions per 100 Medicare services. Theaverage yearly prescribing decreased significantly in the intensive intervention group and increased inthe moderate intervention group, (p=0.026). A mixed effects longitudinal time series model was fittedto the data to account for seasonal variation of antibiotic prescribing and trends over time. Theintensive intervention group significantly reduced their antibiotic prescribing over time compared tothe moderate intervention group, (p<0.001). This study has shown that an intensive intervention inwhich general practitioners were actively engaged in development and consideration of the evidencebase for the guidelines resulted in a significant fall in general antibiotic prescribing
关键词：acute respirator y infections; antibiotic prescribing; antibiotic resistance
