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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

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), pp. 761-767. (doi:10.1183/?09031936.00168409). (PMID:20032009).

Record type: Article


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


Local EPrints ID: 182335
ISSN: 0903-1936
PURE UUID: 20d1e7b9-a728-40eb-94ea-af8110ea9871

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Date deposited: 27 Apr 2011 12:51
Last modified: 18 Jul 2017 11:57

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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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