South American Happy Audit ll

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The aim of Happy Audit ll is to determine the factors associated with prescription of antibiotics in patients with suspected respiratory tract infection I South-America. This is the second report on progress.

Appropriate use of antibiotics is crucial to contain the increase of resistant strains.

172 doctors working at primary care level in six regions in South America [Corrientes (Capital), Misiones y Rafaela (Santa Fe) de Argentina, La Paz (Bolivia), Depto. Itapúa (Paraguay) y Uruguay] are participating in a quality improvement project about use of antibiotics in patients with respiratory tract infection.
The first registration of respiratory tract infections took place from 16 June to 16 August 2014.

Follow-up and research evaluation meetings were held in the different regions during March 2015: 7 March in Posadas (Misiones), Argentina; 10 March in Rafaela (Santa Fe), Argentina; 13 March in Encarnación (Paraguay); 16 March in Montevideo (Uruguay); 25 March in La Paz (Bolivia).

The doctors participated in a four hour meeting in which they received a personal report about use of antibiotics and participated in a focus group about the use of indicators to help them to improve the quality of their prescriptions.

The results of the first audit showed great variation in antibiotic use within each network and between research networks. This variation means we cannot assess the quality of antibiotic use just focusing on the average usage by research network, but the challenge is to improve the use of antibiotics as a group. It means, the reduction of inappropriate use of antibiotics should be accompanied by a homogenization of clinical practice within each network and between networks.

Doctors were asked about the importance of working with quality indicators considering the large group variation when evaluating the prescription of antibiotics, all agreed on the importance of including these indicators: Acute Otitis, acute sinusitis, acute bronchitis and antibiotic use in viral infections, which will be considered in the second register to be carried out from 16 June to 16 August 2015.

The first results and future work was presented at the Ibero-American Congress of Family Medicine in Montevideo (Uruguay) on 20 March 2015.

You are welcome to contact:
Global Coordinator of HAPPY AUDIT:
Professor Lars Bjerrum, GP PhD,
Copenhagen University, Denmark. lbjerrum@sund.ku.dk

Coordinator of HAPPY AUDIT-II SOUTH AMERICA:
Lidia Caballero, GP,
Posadas, Argentina. lijo@arnet.com.ar

On behalf of the steering group;
Gloria Córdoba MD-MPH, PhD fellow,
Copenhagen University, Denmark gloriac@sund.ku.dk