First-line antibiotic prescribing to treat uncomplicated lower urinary tract infection from ITT analysis
| First dispensations | Standard intervention (AF+ES) (n=1685) | Repeated intervention (ES only) (n=1683) | Control (Neither) (n=1683) | |||
| Before (n, %) | After (n, %) | Before (n, %) | After (n, %) | Before (n, %) | After (n, %) | |
| Nitrofurantoin | 2618 (71.7) | 2358 (75.6) | 2428 (68.4) | 2081 (70.8) | 2498 (70.4) | 2091 (69.5) |
| Fosfomycin | 317 (8.7) | 234 (7.5) | 392 (11.0) | 276 (9.4) | 348 (9.8) | 298 (9.9) |
| Ciprofloxacin | 346 (9.5) | 246 (7.9) | 347 (9.8) | 260 (8.8) | 338 (9.5) | 274 (9.1) |
| TMP-SMX | 186 (5.1) | 138 (4.4) | 204 (5.7) | 172 (5.9) | 211 (5.9) | 206 (6.8) |
| Other antibiotics | 184 (5.0) | 143 (4.6) | 181 (5.1) | 151 (5.1) | 154 (4.3) | 141 (4.7) |
| Any antibiotic (total) | 3651 (100) | 3119 (100) | 3552 (100) | 2940 (100) | 3549 (100) | 3010 (100) |
| Secondary outcomes | ||||||
| Nitrofurantoin/100 FPs | 155.4 | 139.9 | 144.1 | 123.5 | 148.2 | 124.1 |
| Other antibiotic/100 FPs | 61.3 | 45.2 | 66.7 | 51.0 | 62.4 | 54.5 |
| Trend: After versus before change in preference | Ratio | Difference | Ratio | Difference | Ratio | Difference |
| Nitrofurantoin | 1.05 | 3.9% | 1.04 | 2.4% | 0.99 | −0.9% |
| Fosfomycin | 0.86 | −1.2% | 0.85 | −1.6% | 1.01 | 0.1% |
| Ciprofloxacin | 0.83 | −1.6% | 0.91 | −0.9% | 0.96 | −0.4% |
| TMP-SMX | 0.87 | −0.7% | 1.02 | 0.1% | 1.15 | 0.9% |
| Other antibiotics | 0.91 | −0.5% | 1.01 | 0.0% | 1.08 | 0.3% |
| Secondary outcomes | Ratio | Difference | Ratio | Difference | Ratio | Difference |
| Nitrofurantoin/100 FPs | 0.90 | −15.4 | 0.86 | −20.6 | 0.84 | −24.2 |
| Other antibiotic/100 FPs | 0.74 | −16.1 | 0.76 | −15.7 | 0.87 | −7.8 |
| Antibiotic-treated UTI | 0.85 | −532 | 0.83 | −612 | 0.85 | −539 |
| Impact | AF+ES versus neither | ES only versus neither | AF+ES versus ES only | |||
| Contrast in trends | Ratio of ratios | Difference in differences | Ratio of ratios | Difference in differences | Ratio of ratios | Difference in differences |
| Nitrofurantoin | 1.07 | 4.8% | 1.05 | 3.3% | 1.02 | 1.5% |
| Fosfomycin | 0.86 | −1.3% | 0.84 | −1.7% | 1.02 | 0.5% |
| Ciprofloxacin | 0.87 | −1.2% | 0.95 | −0.5% | 0.92 | −0.7% |
| TMP-SMX | 0.75 | −1.6% | 0.88 | −0.8% | 0.85 | −0.8% |
| Other antibiotics | 0.84 | −0.8% | 0.93 | −0.3% | 0.90 | −0.5% |
| Secondary outcomes | ||||||
| Nitrofurantoin/100 FPs | 1.08 | 8.7 | 1.02 | 3.6 | 1.05 | 5.2 |
| Other antibiotic/100 FPs | 0.84 | −8.3 | 0.87 | −7.9 | 0.96 | −0.4 |
| Antibiotic-treated UTI | 1.01 | 7 | 0.98 | −73 | 0.96 | 80 |
AF, audit and feedback; ES, educational summary; FP, family physician; ITT, intention-to-treat; TMP-SMX, trimethoprim-sulfamethoxazole; UTI, urinary tract infection.