Education and self-evaluation as tools to improve antibiotic prescriptions at primary care health centers

The Swedish strategic program against antibiotic resistance (Strama) educates health care workers about guidelines of correct antibiotics prescription and informs the general public about the consequences of antibiotic resistance. During 2012 and 2014 two different interventions targeting physicians and nurses took place in nearly all primary care health centers in western Sweden. The first intervention consisted of a visit from a Strama peer at each health center. Every personnel (physicians, nurses) was informed about correct antibiotics prescription, and how the health center prescribed compared to other centers and the region as a whole. The second intervention was conducted by the health center itself; physicians shared their rate of prescriptions for different indications and antibiotics. The team discussed how well they have succeeded to follow the guidelines of antibiotic prescription and possible ways to improve. During this time period, antibiotic prescription rate was reduced, in particular at private health centers. In this study we investigate if the interventions by Strama had a role in this reduction in prescriptions.