Are smokers with acute cough in primary care prescribed antibiotics more often, and to what benefit? - An observational study in 13 European countries


Stanton, N., Hood, K., Kelly , M.J., Nuttall, J., Gillespie, D., Verheij, T., Little, P., Godycki-Cwirko, M., Goossens, H. and Butler, C.C. (2010) Are smokers with acute cough in primary care prescribed antibiotics more often, and to what benefit? - An observational study in 13 European countries. European Respiratory Journal, 35, (4), 761-767. (doi:10.1183/​09031936.00168409). (PMID:20032009).

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Description/Abstract

Little is known about actual clinical practice regarding management of smokers compared with ex-smokers and nonsmokers presenting with acute cough in primary care, and whether a lower threshold for prescribing antibiotics benefits smokers.

This was a multicentre 13-country European prospective observational study of primary care clinician management of acute cough in consecutive immunocompetent adults presenting with an acute cough of ≤28 days duration.

There was complete smoking status data for 2,549 out of 3,402 participants. 28% were smokers, 24% ex-smokers and 48% nonsmokers. Smokers and ex-smokers had more chronic respiratory conditions (18.5% and 20.5% versus 12.5%). Median symptom severity scores were similar. Smokers were prescribed antibiotics more frequently (60%) than ex-smokers (51%) and nonsmokers (53%). After adjusting for clinical presentation and patient characteristics, the odds ratio of being prescribed antibiotics for smokers compared with nonsmokers was 1.44 (95% CI 1.12–1.86; p = 0.005). Patient recovery was not significantly different for smokers and nonsmokers, after adjusting for clinical presentation and patient characteristics.

Smoking status was used as an independent factor to determine whether or not to prescribe an antibiotic. Being prescribed an antibiotic was not associated with recovery in smokers.

Item Type: Article
ISSNs: 0903-1936 (print)
1399-3003 (electronic)
Keywords: adults, antimicrobial therapy (antibiotics), cough, health, smoking
Subjects: H Social Sciences > HA Statistics
H Social Sciences > HV Social pathology. Social and public welfare
R Medicine > RA Public aspects of medicine > RA0421 Public health. Hygiene. Preventive Medicine
Divisions: University Structure - Pre August 2011 > School of Medicine > Community Clinical Sciences
ePrint ID: 182335
Date Deposited: 27 Apr 2011 12:51
Last Modified: 27 Mar 2014 19:35
URI: http://eprints.soton.ac.uk/id/eprint/182335

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