Evidence map›Paper›PMID 40094204›Full record

ArticleFamily practice2025

Changing the antibiotic prescribing of Australian general practice registrars' for acute respiratory tract infections: a non-randomized controlled trial.

Alexandria Turner, Mieke L van Driel, Benjamin L Mitchell, Joshua S Davis, Amanda Tapley, Elizabeth Holliday, Jason Dizon, Paul Glasziou, Mina Bakhit, Katie Mulquiney and 7 more

Abstract read
In one paragraph

Article in Family practice, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 2 papers.

0numbers the graph read from it
0cells of the map it votes in
2citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

2 citing papers in PubMed.

  1. Trial
  2. Article
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

17 authors.

Alexandria TurnerGeneral Practice Clinical Unit, Faculty of Medicine, The University of Queensland, Herston, 4029, QLD, Australia.ORCID 0000-0002-8558-5321
Mieke L van DrielGeneral Practice Clinical Unit, Faculty of Medicine, The University of Queensland, Herston, 4029, QLD, Australia.ORCID 0000-0003-1711-9553
Benjamin L MitchellGeneral Practice Clinical Unit, Faculty of Medicine, The University of Queensland, Herston, 4029, QLD, Australia.
Joshua S DavisSchool of Medicine and Public Health, University of Newcastle, Callaghan, 2308, NSW, Australia.
Amanda TapleySchool of Medicine and Public Health, University of Newcastle, Callaghan, 2308, NSW, Australia.
Elizabeth HollidaySchool of Medicine and Public Health, University of Newcastle, Callaghan, 2308, NSW, Australia.
Jason DizonHunter Medical Research Institute, Data Sciences, New Lambton Heights, 2305, NSW, Australia.
Paul GlasziouFaculty of Health Sciences and Medicine, Bond University, Robina, 4229, QLD, Australia.ORCID 0000-0001-7564-073X
Mina BakhitFaculty of Health Sciences and Medicine, Bond University, Robina, 4229, QLD, Australia.ORCID 0000-0002-6162-3362
Katie MulquineySchool of Medicine and Public Health, University of Newcastle, Callaghan, 2308, NSW, Australia.
Andrew DaveySchool of Medicine and Public Health, University of Newcastle, Callaghan, 2308, NSW, Australia.
Katie FisherSchool of Medicine and Public Health, University of Newcastle, Callaghan, 2308, NSW, Australia.ORCID 0000-0002-2256-2624
Emma J BaillieGeneral Practice Clinical Unit, Faculty of Medicine, The University of Queensland, Herston, 4029, QLD, Australia.
Alison FieldingSchool of Medicine and Public Health, University of Newcastle, Callaghan, 2308, NSW, Australia.
Dominica MoadSchool of Medicine and Public Health, University of Newcastle, Callaghan, 2308, NSW, Australia.
Anthea DallasGP Training Research, Royal Australian College of General Practitioners, Mayfield West, 2304, NSW, Australia.
Parker MaginSchool of Medicine and Public Health, University of Newcastle, Callaghan, 2308, NSW, Australia.ORCID 0000-0001-8071-8749

Funding

Adelaide to Outback GP Training ProgramAustralian Department of HealthCentre for Research Excellence in Minimizing Antibiotic ResistanceCommunity and Mina Bakhit's 1153299Eastern Victoria General Practice TrainingGeneral Practice Training TasmaniaGeneral Practice Training Valley to CoastGP SynergyGP Synergy Regional Training OrganizationNational Health and Medical Research CouncilReCEnTTropical Medical TrainingVictorian Metropolitan Alliance
6 · The paper itself

Abstract

backgroundInappropriate antibiotic prescription for self-limiting respiratory tract infections (RTIs) by general practitioner (GP) registrars (trainees) is less common than by established GPs but still exceeds evidence-based benchmarks. A 2014 face-to-face educational intervention for registrars and supervisors reduced registrars' acute bronchitis antibiotic prescription by 16% (absolute reduction). We aimed to establish the efficacy of an updated registrar/supervisor RTI-management intervention (delivered at distance) on antibiotic prescribing.

methodsA non-randomized trial using a non-equivalent control-group nested within the ReCEnT cohort study. The intervention included online educational modules, registrar and supervisor webinars, and materials for registrar-supervisor in-practice educational sessions, and focussed on acute bronchitis as an exemplar RTI. The theoretical underpinning was the 'capability, opportunity, and motivation' (COM-B) framework. The intervention was delivered to registrars and supervisors of one large educational/training organization annually from mid-2021, with pre-intervention period from 2017, and with postintervention period ending 2023. Two other educational/training organizations served as controls. The primary outcome was antibiotics prescribed for acute bronchitis. Analyses used multivariable logistic regression with predictors of interest: time (before/after intervention), treatment group, and an interaction term for time-by-treatment group, adjusted for potential confounders. The interaction term P-value was used to infer statistical significance of the intervention effect.

resultsOf 4612 acute bronchitis presentations, 70% were prescribed antibiotics. There was a 6.9% absolute reduction (adjusted) of prescribing in the intervention-group compared with the control-group. This was not statistically significant (Pinteraction = .22).

conclusionsFailure to find a significant effect on prescribing suggests difficulties with scalability of this (and similar educational) innovations.

Indexed as

Anti-Bacterial AgentsGeneral PracticeGeneral PractitionersInappropriate PrescribingPractice Patterns, Physicians'Respiratory Tract InfectionsAcute DiseaseAdultAustraliaBronchitisFemaleHumansMaleMiddle AgedAnti-Bacterial Agentsanti-bacterial agentsantimicrobial stewardshipgeneral practitionersgraduate medical educationnon-randomized controlled trialsrespiratory tract infections

Identifiers

PMID40094204
PMCPMC11911915

What OpenQuestion holds

Textmetadata
LicenceCC BY-NC
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Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.