Internet-Based Training Program can Trigger a Two-Thirds Drop in Antibiotic Prescription Rates

Paul Little, Professor of Primary Care Research at the University of Southampton, comments: "The high volume of prescribing antibiotics in primary care is a major driver of antibiotic resistance, which is one of the great public health dangers of our time, and raises the real prospect of serious infections becoming untreatable.

"Training has been shown to have a positive effect on lowering prescription rates but the way training has been delivered and its reliance on highly trained staff around centres of excellence severely limits the impact in everyday practice. Novel techniques are therefore needed to lead changes at a national and international level. Internet training has the advantage that it can be disseminated widely at a low cost and does not need much resource."

Lower respiratory tract infections (LRTI), such as chest infections like bronchitis, are one of the most common acute illnesses treated in primary care in developed countries. Although viruses are believed to cause most of these infections, there is still debate about whether or not antibiotics are beneficial for some patients in the treatment of LRTI, particularly in older patients. Meanwhile antibiotics are still being prescribed in high amounts, fuelling antibiotic resistance.

In the study, from the GRACE (Genomics to Combat Resistance against Antibiotics in Community-acquired LRTI in Europe) consortium and funded by the European Community's Sixth Framework Programme, 246 clinical practices from six countries were recruited. They were randomised to one of four trial arms: usual care, internet-based training to use a C-reactive protein (CRP) test (an indicator test for pneumonia), internet-based training in enhanced communication skills, and combined training in both CRP and enhanced communication.

The study, supported by the National Institute for Health Research Clinical Research Network in England, showed that clinicians who received training in using the CRP test or the enhanced communications skills training significantly reduced their antibiotic prescribing rates for LRTI, compared to usual care (47 per cent and 32 per cent respectively). Furthermore, clinicians who received training in a combination of both reduced prescribing antibiotics by 62 per cent.

Additionally prescribing rates also fell for upper respiratory tract infections (e.g. colds, influenza, and throat, ear and sinus infections). These infections were not targeted by the intervention, which suggests that further modifications could be made to the internet training to better address these conditions, which would maximise the impact of training.

Professor Little adds: "These interventions have shown that providing interactive training methods using the internet to modify antibiotic prescribing is remarkably effective. Moreover the internet-based training programmes are transferrable between very different primary care settings."

Source-Eurekalert

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Safe Drinking Water in Colombia Tackled By American Chemical Society Global Program

by Rukmani Krishna on? June 24, 2013 at 11:42 PM General Health News A white paper outlining possible solutions for increasing access to safe drinking water in the rural areas of the world was issued by the Global Innovation Imperatives (Gii) program, administered by the American Chemical Society (ACS) Office of International Activities. Although focused on the community of Chocont?, in Colombia, the suggested solutions have broader application.
Chocont? residents rely on rural aqueducts for their water, but supplies are vulnerable to pollution from nearby agriculture and largely go untreated. City officials asked ACS, the world's largest scientific society, to help solve the problem, noting that the solutions likely would apply to other areas of the country and possibly the world.

"The recommendations in this report should solve local problems but could be easily replicated elsewhere," said Francisco Gomez, assistant director of the ACS Office of International Activities. "If other areas in the region have this same problem, there is a good probability that the recommendations will offer solutions."

Gii's mission is to solve global challenges such as increasing access to safe drinking water and ensuring food security, Gomez explained. The approach involves bringing together experts within ACS, as well as other scientific societies and nongovernmental organizations, to share knowledge and expertise and propose innovative solutions ? essentially building a community around a problem.

To produce the Chocont? report, ACS partnered with the Colombian Society of Chemical Sciences (SOCOLQUIM), the Brazilian Chemical Society and the Latin American Federation of Chemical Associations, along with experts from the U.S. Geological Survey and Conservaci?n Internacional. The team conducted field visits to work toward the goal of providing clean water for all residents of the community.

The recommendations in the new report came out of discussions at the International Forum on Sustainable Conservation of Water Sources & Basins & Operation of Sidewalk Aqueducts of Chocont?, which was held in Bogot?, Colombia, in October 2012.

This is the second report issued by Gii. Its first white paper outlined recommendations for sustainable and cost-effective solutions to water quality challenges in India.

Gii's next forum, scheduled to take place later this year, will address water scarcity in a community in the south of Brazil. A white paper with recommendations will follow.

Source-Eurekalert

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Stroke patients perform better in Get with the guidelines (Regd) - racing program

"Previous studies have shown get with the guidelines hospitals improved the manner in which they have taken in charge for people, but it is the first to show how the recovery tempeature patient.".The researchers compared 366 hospitals that joined the programme of the American Heart Association/American Stroke Association get with lines guidelines-race in April 2004-December 2007 with 366 that did not.

They correspond to installations of size, geographical location, State of education, number of treated strokes and patients characteristics.Comparing the periods before and after hospitals joined to get with the guidelines, researchers found that participating hospitals improved their mortality rate 30 days and one year and a rate of readmission 30 days and one year. During the same time, only improved non-participating hospitals 30-day mortality rates.

Hospitals get with the guidelines-Stroke lines also had higher rates of discharge patients directly at home rather than in a care facility.More than 2,000 hospitals participate in several programmes to get with the guidelines of the association, which provide resources and tools to help care teams to follow the most recent treatment guidelines based on research.

Source-Eurekalert

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