Multi-faceted intervention to improve antibiotic use in ambulatory care: a cluster-randomised controlled trial
Antibiotic resistance is one of the principal public health problems world-wide. Inappropriate use of antibiotics is currently regarded as the main determinant of such resistance.
1. The attitudes and knowledge towards antibiotics generate habits of prescription
2. The identification of the attitudes, knowledge and factors that generate habits of inadequate prescription will allow the design of specific educative interventions to improve the use of antibiotics
3. The intervention designed from gaps detected in knowledge and attitudes with respect to antibiotics and resistance will improve the prescription of antibiotics
4. The intervention will collaborate in the control of the bacterial resistance
Spanish accredited Ethics Committee (Comité Ético de Investigación Clínica de Galicia) gave approval in May 2007 (ref: 2007/052)
Cluster randomised controlled trial
Primary study design
Secondary study design
Randomised controlled trial
Patient information sheet
Not available in web format, please use the contact details below to request a participant information sheet
This is a cluster randomised controlled trial covering all general practitioners in a northwest region of Spain (Galicia). A specific educative intervention, designed from gaps detected in knowledge and attitudes with respect to antibiotics and resistance, will be carried out on the intervention group. The control group will not receive any specific intervention.
The intervention will consist of group outreach visits (40 minutes), and will be targeted at changing the knowledge-attitudes previously found to be associated with poor prescribing of antibiotics. An observational cohort study of a sample of 1500 primary care physicians will be carried out to identify knowledge-attitudes associated with inappropriate prescribing of antibiotics. The independent variables (knowledge-attitudes) will be assessed by a self-administered postal questionnaire and dependent variables are some quantity and quality indicators of the prescribing antibiotics.
Primary outcome measure
Various quality indicators of the prescribing of antibiotics, assessed based on Infectious Diseases Clinical guidelines in Primary Care, measured monthly from the last intervention to the end of study.
Secondary outcome measures
Various quantity indicators of the prescribing of antibiotics, measured monthly from the last intervention to the end of study.
Overall trial start date
Overall trial end date
Reason abandoned (if study stopped)
Participant inclusion criteria
1. General practitioners working during the period of the study (October 2007 to October 2010)
2. Aged approximately 30 - 60 years old, female or male
Target number of participants
Estimated to include 3000 GPs (1500 at intervention group and 1500 at control group)
Participant exclusion criteria
General practitioners who work for private insurances during the period of the study (October 2007 to October 2010).
Recruitment start date
Recruitment end date
Countries of recruitment
Trial participating centre
Departamento de Salud Pública
Santiago de Compostela
The Foundation for Medical Research Mutua Madrileña (Fundación de Investigación Médica Mutua Madrileña) (Spain)
The Foundation for Medical Research Mutua Madrileña (Fundación de Investigación Médica Mutua Madrileña) (Spain) - grant received
Funding Body Type
Funding Body Subtype
Results and Publications
Publication and dissemination plan
Not provided at time of registration
Intention to publish date
Participant level data
Not provided at time of registration
Basic results (scientific)