OBJECTIVES: : To measure and improve antibiotic use for acute @entity1729 (ARIs) in the elderly. DESIGN: : Prospective, nonrandomized controlled trial. SETTING: : Ambulatory office practices in Denver metropolitan area (n=4 intervention practices; n=51 control practices). @entity1 : : Consecutive @entity1 enrolled in a Medicare managed care program who were diagnosed with ARIs during baseline (winter 2000/2001) and intervention (winter 2001/2002) periods. A total of 4,270 @entity1 visits were analyzed (including 341 @entity1 visits in intervention practices). INTERVENTION: : Appropriate antibiotic use and antibiotic resistance educational materials were mailed to intervention practice households. Waiting and examination room posters were provided to intervention office practices. MEASUREMENTS: : Antibiotic prescription rates, based on administrative office visit and pharmacy data, for total and condition-specific ARIs. RESULTS: : There was wide variation in antibiotic prescription rates for ARIs across unique practices, ranging from 21% to 88% (median=54%). Antibiotic prescription rates varied little by @entity1 age, sex, and underlying @entity1030 . Prescription rates varied by diagnosis: @entity1244 (69%), @entity3617 (59%), @entity7551 (50%), and nonspecific @entity1729 (26%). The educational intervention was not associated with greater reduction in antibiotic prescription rates for total or condition-specific ARIs beyond a modest secular trend (P=.79). CONCLUSION: : Wide variation in antibiotic prescription rates suggests that quality improvement efforts are needed to optimize antibiotic use in the elderly. In the setting of an ongoing physician intervention, a @entity1 education intervention had little effect. Factors other than @entity1 expectations and demands may play a stronger role in antibiotic treatment decisions in elderly populations.

Antibiotic treatment of acute XXXX in the elderly: effect of a multidimensional educational intervention.

@entity1 :: ('9606', 'Species') :: ['patients', 'patient', 'PARTICIPANTS'] @entity3617 :: ('MESH:D001991', 'Disease') :: ['bronchitis'] @entity1244 :: ('MESH:D012852', 'Disease') :: ['sinusitis'] @entity7551 :: ('MESH:D010612', 'Disease') :: ['pharyngitis'] @entity1729 :: ('MESH:D012141', 'Disease') :: ['respiratory tract infections', 'upper respiratory tract infection'] @entity1030 :: ('MESH:D029424', 'Disease') :: ['chronic lung disease']
@entity1729 :: (MESH:D012141,Disease) :: ['respiratory tract infections']
