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

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

adults, antimicrobial therapy (antibiotics), cough, health, smoking
0903-1936
761-767
Stanton, N.
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Hood, K.
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Kelly, M.J.
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Nuttall, J.
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Gillespie, D.
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Verheij, T.
cc355b92-ba85-4102-98a0-cee55f0504f6
Little, P.
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Godycki-Cwirko, M.
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Goossens, H.
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Butler, C.C.
736f78ad-3e18-4c63-900f-c2249577b645
Stanton, N.
c7217c86-f924-4d99-9170-4ce9e751809c
Hood, K.
12e14eb3-2c75-409f-a69d-add733644d89
Kelly, M.J.
490f28a3-e40d-4005-bf8c-7b41a21bfb60
Nuttall, J.
b5ae8614-d0fa-4488-80f6-33593bb48129
Gillespie, D.
1af28184-1f5b-477f-a9ba-2281b7221aa7
Verheij, T.
cc355b92-ba85-4102-98a0-cee55f0504f6
Little, P.
1bf2d1f7-200c-47a5-ab16-fe5a8756a777
Godycki-Cwirko, M.
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Goossens, H.
533640f7-b568-4d95-a7c1-28158d154ba8
Butler, C.C.
736f78ad-3e18-4c63-900f-c2249577b645

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)

Record type: Article

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.

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More information

Published date: April 2010
Keywords: adults, antimicrobial therapy (antibiotics), cough, health, smoking

Identifiers

Local EPrints ID: 182335
URI: http://eprints.soton.ac.uk/id/eprint/182335
ISSN: 0903-1936
PURE UUID: 20d1e7b9-a728-40eb-94ea-af8110ea9871

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Date deposited: 27 Apr 2011 12:51
Last modified: 08 Jan 2022 05:33

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Contributors

Author: N. Stanton
Author: K. Hood
Author: M.J. Kelly
Author: J. Nuttall
Author: D. Gillespie
Author: T. Verheij
Author: P. Little
Author: M. Godycki-Cwirko
Author: H. Goossens
Author: C.C. Butler

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