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Journal of Biomedical Education
Volume 2014 (2014), Article ID 537681, 6 pages
Research Article

A Continuing Medical Education Campaign to Improve Use of Antibiotics in Primary Care

1Office of Continuing Medical Education and Professional Development, University of Colorado Denver, 13001 East 17th Place, C-295, Aurora, CO 80045, USA
2Department of Obstetrics and Gynecology, University of Colorado School of Medicine, 12631 East 17th Avenue, MS 198-5, Aurora, CO 80045, USA
3Department of Internal Medicine, Denver Health, 660 Bannock Street, Denver, CO 80204, USA

Received 25 February 2014; Accepted 13 May 2014; Published 25 May 2014

Academic Editor: Friedrich Paulsen

Copyright © 2014 Ronald S. Gibbs et al. This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.


Because inappropriate use of antibiotics is common, it is an important area for continuing medical education. At an annual review, we conducted a two-year campaign to achieve appropriate use. Our methods included two surveys, directed course content, programmatic evaluation, and a sample practice audit. Ninety percent of learners perceived inappropriate antibiotic use as a “very big” or “big” problem in the United States, but only 44% perceived this about their practice ( ). Top perceived barriers to appropriate antibiotic use were patient expectations, breaking old habits, and fear that patients would go elsewhere. Top strategies to overcome these barriers were patient educational materials, having guidelines accessible, and developing practice policies. In a hypothetical patient with acute bronchitis, 98% would likely prescribe an antibiotic in certain clinical scenarios even though The Centers for Disease Control and Prevention does not recommend empiric antibiotic treatment. The most common scenarios leading to likely antibiotic prescription were symptoms over 15 days (84%), age over 80 years (70%), and fever (48%). Practitioners are under multiple pressures to prescribe antibiotics even in situations where antibiotics are not recommended (such as acute bronchitis). To achieve complex practice changes such as avoiding inappropriate antibiotic use, no one strategy predominated.