Is it possible to decrease antibiotic prescribing in primary care? An analysis of outcomes in the management of patients with sore throats

Objectives. The aim of this study was to assess whether it was possible to change clinical practice through the introduction of an evidence-based protocol for the management of so re throats. The impact of the changed clinical practice on patients was also assessed. Method. An observational study was carried out comparing management of patients with sore throats in a semi-rural general practice (14 000 patients), before and after the introduction of an evidence-based protocol, using a multidisciplinary approach. All patients over the age of 2 years presenting with sore throats as their chief presenting complaint were included in the study which ran for two 6-month periods: February-July 1997 (n = 435) and February-July 1998 (n = 350). Antibiotic prescribing rates, consultation and reconsultation rates, duration of sore throat, analgesia requirements and satisfaction were assessed. Results. Antibiotic prescribing was significantly reduced in period 2 (56% compared with 19%). Consultation rates decreased by 19% in period 2. Median number of days to recovery of sore throats was the same in both groups. Reconsultation rates and dissatisfaction rates were the same in both groups. Conclusion. Using a multidisciplinary approach, it is possible to reduce antibiotic prescribing for sore throats significantly without adversely affecting outcome.