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Delayed antibiotic prescribing and associated antibiotic consumption in adults with acute cough

Delayed antibiotic prescribing and associated antibiotic consumption in adults with acute cough
Delayed antibiotic prescribing and associated antibiotic consumption in adults with acute cough
Background: delayed antibiotic prescribing is promoted as a strategy to reduce antibiotic consumption, but its use and its effect on antibiotic consumption in routine care is poorly described.

Aim: to quantify delayed antibiotic prescribing in adults presenting in primary care with acute cough/lower respiratory tract infection (LRTI), duration of advised delay, consumption of delayed antibiotics, and factors associated with consumption.

Design and setting: prospective observational cohort in general practices in 14 primary care networks in 13 European countries.

Method: GPs recorded clinical features and antibiotic prescribing for adults presenting with an acute infective illness with cough as the dominant symptom. Patients recorded their consumption of antibiotics from any source during the 28-day follow up.

Results: two hundred and ten (6.3%) of 3368 patients with usable consultation data were prescribed delayed antibiotics. The median recommended delay period was 3 days. Seventy-five (44.4%) of the 169 with consumption data consumed the antibiotic course and a further 18 (10.7%) took another antibiotic during the study period. 50 (29.6%) started their delayed course on the day of prescription. Clinician diagnosis of upper respiratory tract/viral infection and clinician's perception of patient's wanting antibiotics were associated with less consumption of the delayed prescription. Patient's wanting antibiotics was associated with greater consumption.

Conclusion: delayed antibiotic prescribing was used infrequently for adults presenting in general practice with acute cough/LRTI. When used, the effect on antibiotic consumption was less than found in most trials. There are opportunities for standardising the intervention and promoting wider uptake
0960-1643
e639-e646
Francis, Nick A.
4fef3cf0-2dda-4294-bde7-e29eb33bbfdc
Gillespie, David
a1389d8b-011c-408e-8064-2ce4ccf3312a
Nuttall, Jacqueline
1e454af7-f89e-4e93-b537-bc3a04989ad1
Hood, Kerenza
62906d76-4931-4b12-9a64-0c867c7b84c1
Little, Paul
1bf2d1f7-200c-47a5-ab16-fe5a8756a777
Verheij, Theo
772e019f-486f-4a64-9260-bac6446a85d2
Goossens, Herman
31f8e1ae-7da0-473c-bd49-f911c2187451
Coenen, Samuel
3d0dc4e0-e5ba-4d66-ba92-15900ccc551e
Butler, Christopher C.
2782a915-eb8d-48bb-ae70-118114697f57
Francis, Nick A.
4fef3cf0-2dda-4294-bde7-e29eb33bbfdc
Gillespie, David
a1389d8b-011c-408e-8064-2ce4ccf3312a
Nuttall, Jacqueline
1e454af7-f89e-4e93-b537-bc3a04989ad1
Hood, Kerenza
62906d76-4931-4b12-9a64-0c867c7b84c1
Little, Paul
1bf2d1f7-200c-47a5-ab16-fe5a8756a777
Verheij, Theo
772e019f-486f-4a64-9260-bac6446a85d2
Goossens, Herman
31f8e1ae-7da0-473c-bd49-f911c2187451
Coenen, Samuel
3d0dc4e0-e5ba-4d66-ba92-15900ccc551e
Butler, Christopher C.
2782a915-eb8d-48bb-ae70-118114697f57

Francis, Nick A., Gillespie, David, Nuttall, Jacqueline, Hood, Kerenza, Little, Paul, Verheij, Theo, Goossens, Herman, Coenen, Samuel and Butler, Christopher C. (2012) Delayed antibiotic prescribing and associated antibiotic consumption in adults with acute cough. British Journal of General Practice, 62 (602), e639-e646. (doi:10.3399/bjgp12X653561). (PMID:22947585)

Record type: Article

Abstract

Background: delayed antibiotic prescribing is promoted as a strategy to reduce antibiotic consumption, but its use and its effect on antibiotic consumption in routine care is poorly described.

Aim: to quantify delayed antibiotic prescribing in adults presenting in primary care with acute cough/lower respiratory tract infection (LRTI), duration of advised delay, consumption of delayed antibiotics, and factors associated with consumption.

Design and setting: prospective observational cohort in general practices in 14 primary care networks in 13 European countries.

Method: GPs recorded clinical features and antibiotic prescribing for adults presenting with an acute infective illness with cough as the dominant symptom. Patients recorded their consumption of antibiotics from any source during the 28-day follow up.

Results: two hundred and ten (6.3%) of 3368 patients with usable consultation data were prescribed delayed antibiotics. The median recommended delay period was 3 days. Seventy-five (44.4%) of the 169 with consumption data consumed the antibiotic course and a further 18 (10.7%) took another antibiotic during the study period. 50 (29.6%) started their delayed course on the day of prescription. Clinician diagnosis of upper respiratory tract/viral infection and clinician's perception of patient's wanting antibiotics were associated with less consumption of the delayed prescription. Patient's wanting antibiotics was associated with greater consumption.

Conclusion: delayed antibiotic prescribing was used infrequently for adults presenting in general practice with acute cough/LRTI. When used, the effect on antibiotic consumption was less than found in most trials. There are opportunities for standardising the intervention and promoting wider uptake

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More information

Published date: September 2012
Organisations: Primary Care & Population Sciences

Identifiers

Local EPrints ID: 349990
URI: http://eprints.soton.ac.uk/id/eprint/349990
ISSN: 0960-1643
PURE UUID: 63df5b9a-c339-4bfe-9155-f28a321cff54

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Date deposited: 15 Mar 2013 10:03
Last modified: 08 Nov 2021 23:42

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Contributors

Author: Nick A. Francis
Author: David Gillespie
Author: Jacqueline Nuttall
Author: Kerenza Hood
Author: Paul Little
Author: Theo Verheij
Author: Herman Goossens
Author: Samuel Coenen
Author: Christopher C. Butler

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