How effective is a brief educational intervention on prescribing first-line antibiotics in acute cystitis? A quasi-experimental study among general practitioners in Croatia

Aim To assess the effectiveness of a brief educational inter-vention on prescribing first-line antibiotics in acute cystitis.Methods This quasi-experimental before-after study was conducted over a period of eight months. We collected pre-scribing data related to urinary tract infections four months before the educational intervention and four months after it. Aggregate data on office visits, diagnoses, and issued prescriptions were collected from each practice's electronic medical records based on monthly reports.Results Overall, 3581 prescriptions were issued: 1717 be-fore and 1864 after the intervention. The total number of prescriptions increased by 8.5%. The use of first-line antibi-otics increased by 21.2%, the use of fluoroquinolones de-creased by 6.6%, while the use of beta-lactams remained unchanged. After the intervention, nitrofurantoin was the most prescribed first-line antibiotic. The proportion of women who were prescribed first-line antibiotic did not reach the acceptable range (80%-100%) according to the European Surveillance of Antimicrobial Consumption qual-ity indicators. The proportion of fluoroquinolones (17.9%) use was well above the acceptable range (0%-5%).Conclusion A brief educational intervention proved to be a useful method in adopting better prescribing habits. Of particular importance is the considerable increase in the use of nitrofurantoin due to its reliable efficacy against multidrug-resistant urinary pathogens.