Effectiveness of doctors’ advice on non-prescription antibiotic use: a randomized controlled trial, China

Le résumé fourni par la source

Objective: To evaluate a family doctor-led, community-based intervention to reduce non-prescription antibiotic use. Methods: We conducted a parallel-group, cluster-randomized controlled trial at 22 community health centres in Shenzhen, China, over an 8-month period in 2023. We randomly (1 : 1) assigned community health centres to provide a 4-week, family doctor-led, community-based online health intervention, or to provide routine care only. Eligible participants were adults aged 18 to 75 years who had resided in the community for more than 6 months. The primary outcome was the level of non-prescription antibiotic use (including self-medication with antibiotics and purchase of antibiotics without a prescription). Secondary outcomes were: levels of self-medication with antibiotics; purchase of antibiotics without a prescription; self-storage of antibiotics; and prescribed antibiotic use. Findings: We enrolled 1550 participants, with 788 assigned to the intervention group and 762 to the control group. We observed a significant decrease in non-prescription antibiotic use in the intervention group compared to the control group (odds ratio, OR: 0.49; 95% confidence interval, CI: 0.31-0.77) at 6 months. There was a significant reduction in self-medication (OR: 0.33; 95% CI: 0.13-0.83) and purchase of antibiotics without a prescription (OR: 0.59; 95% CI: 0.37-0.94), but not in self-storage (OR: 0.80; 95% CI: 0.54-1.18) or prescribed antibiotic use (OR: 0.94; 95% CI: 0.48-1.87) at 6 months. Conclusion: The family doctor-led, community-based intervention demonstrated promising effectiveness and feasibility. This study provides valuable insights for the design and implementation of such interventions aimed at promoting rational use of antibiotics.

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