Literature DB >> 19713006

[Antibiotic prescribing in respiratory tract infections and predictive factors for their use].

Carles Llor1, Josep María Cots, Lars Bjerrum, Marina Cid, Gloria Guerra, Xavier Arranz, Manuel Gómez, María José Monedero, Juan de Dios Alcántara, Carolina Pérez, Guillermo García, Jesús Ortega, María Luisa Cigüenza, Vicenta Pineda, José Paredes, Juan Luis Burgazzoli, Silvia Hernández.   

Abstract

OBJECTIVE: Happy Audit project is a European-funded survey aimed at reducing antibiotic prescribing for respiratory tract infections (RTI). The aim of this study is to investigate the antibiotic treatment administered for these RTIs in Spain and to find out which criteria are associated with its use.
DESIGN: Cross-sectional study carried out in January and February 2008.
SETTING: Primary health care. PARTICIPANTS: General practitioners registered all the RTI during a 3-week period using a template. PRINCIPAL MEASUREMENTS: Age and gender, days with symptoms, signs presented (fever, cough, purulent ear discharge, sore throat, tonsillar exudate, swollen neck glands, dyspnoea, increase in sputum, purulent sputum), diagnosis, antibiotic therapy and demand of antibiotics. A logistic regression with the prescription of antibiotic as the dependent variable was performed.
RESULTS: Out of the 332 physicians invited to participate, 309 filled in and returned the templates (93.1%), registering 16,751 RTIs, with the common cold (39.7%), pharyngitis (14.4%) and acute bronchitis (12.6%) being the most common. Antibiotic therapy was given to 4,675 RTIs (27.9%), mainly for pneumonia (89.9%), tonsillitis (88.9%), and otitis media (87.3%). The criterion most associated with antibiotic therapy was the presence of tonsillar exudate (OR: 32.1; 95CI%: 24.5-42), followed by ear discharge (25.2; 95%CI: 18.2-35) and purulence of sputum (18.1; 95%CI: 15.5-21.2); conversely, cough (OR: 0.4; 95%CI: 0.3-0.5) was considered as protective factor. DISCUSSION: Antibiotic treatment for RTIs is very high in our country. This study provides information on the criteria that predict this antibiotic therapy and is important to take into account if a more rational use of antibiotics is required. Copyright (c) 2009 Elsevier España, S.L. All rights reserved.

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Year:  2009        PMID: 19713006      PMCID: PMC7022111          DOI: 10.1016/j.aprim.2009.04.018

Source DB:  PubMed          Journal:  Aten Primaria        ISSN: 0212-6567            Impact factor:   1.137


  19 in total

1.  Variation in antibiotic use in the European Union.

Authors:  O Cars; S Mölstad; A Melander
Journal:  Lancet       Date:  2001-06-09       Impact factor: 79.321

2.  The effect of changes in the consumption of macrolide antibiotics on erythromycin resistance in group A streptococci in Finland. Finnish Study Group for Antimicrobial Resistance.

Authors:  H Seppälä; T Klaukka; J Vuopio-Varkila; A Muotiala; H Helenius; K Lager; P Huovinen
Journal:  N Engl J Med       Date:  1997-08-14       Impact factor: 91.245

3.  Practice characteristics associated with audit activity: a medical audit advisory group survey.

Authors:  B Lervy; K Wareham; W Y Cheung
Journal:  Br J Gen Pract       Date:  1994-07       Impact factor: 5.386

Review 4.  Antibiotics for upper respiratory tract infections: an overview of Cochrane reviews.

Authors:  B Arroll
Journal:  Respir Med       Date:  2005-03       Impact factor: 3.415

5.  Outpatient antibiotic use in Europe and association with resistance: a cross-national database study.

Authors:  Herman Goossens; Matus Ferech; Robert Vander Stichele; Monique Elseviers
Journal:  Lancet       Date:  2005 Feb 12-18       Impact factor: 79.321

6.  A European study on the relationship between antimicrobial use and antimicrobial resistance.

Authors:  Stef L A M Bronzwaer; Otto Cars; Udo Buchholz; Sigvard Mölstad; Wim Goettsch; Irene K Veldhuijzen; Jacob L Kool; Marc J W Sprenger; John E Degener
Journal:  Emerg Infect Dis       Date:  2002-03       Impact factor: 6.883

7.  Randomised controlled trial of antibiotics in patients with cough and purulent sputum.

Authors:  N C Stott; R R West
Journal:  Br Med J       Date:  1976-09-04

8.  The diagnosis of strep throat in adults in the emergency room.

Authors:  R M Centor; J M Witherspoon; H P Dalton; C E Brody; K Link
Journal:  Med Decis Making       Date:  1981       Impact factor: 2.583

9.  Antibiotic therapy in exacerbations of chronic obstructive pulmonary disease.

Authors:  N R Anthonisen; J Manfreda; C P Warren; E S Hershfield; G K Harding; N A Nelson
Journal:  Ann Intern Med       Date:  1987-02       Impact factor: 25.391

Review 10.  Exacerbations of chronic obstructive pulmonary disease: when are antibiotics indicated? A systematic review.

Authors:  Milo A Puhan; Daniela Vollenweider; Tsogyal Latshang; Johann Steurer; Claudia Steurer-Stey
Journal:  Respir Res       Date:  2007-04-04
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  9 in total

1.  [Does a pharyngeal culture have to be requested when using rapid antigen techniques?].

Authors:  Carles Llor
Journal:  Aten Primaria       Date:  2010-05-13       Impact factor: 1.137

2.  Impact on antibiotic prescription of rapid antigen detection testing in acute pharyngitis in adults: a randomised clinical trial.

Authors:  Carl Llor; Jordi Madurell; Montse Balagué-Corbella; Mónica Gómez; Josep Maria Cots
Journal:  Br J Gen Pract       Date:  2011-05       Impact factor: 5.386

3. 

Authors:  María José Monedero Mira; Manuel Batalla Sales; Concepción García Domingo; María José Monedero Mira; Belén Persiva Saura; Gloria Rabanaque Mallen; Lledó Tárrega Porcar
Journal:  FMC       Date:  2016-04-26

4.  Effectiveness of anti-inflammatory treatment versus antibiotic therapy and placebo for patients with non-complicated acute bronchitis with purulent sputum. The BAAP Study protocol.

Authors:  Carl Llor; Ana Moragas; Carolina Bayona; Rosa Morros; Helena Pera; Josep M Cots; Yvonne Fernández; Marc Miravitlles; Albert Boada
Journal:  BMC Pulm Med       Date:  2011-06-21       Impact factor: 3.317

5.  Debunking myths: The utilisation of antibiotics in primary care in Spain.

Authors:  Carles Llor
Journal:  Aten Primaria       Date:  2017-03       Impact factor: 1.137

Review 6.  [Recommendations for management of acute pharyngitis in adults].

Authors:  Josep M Cots; Juan-Ignacio Alós; Mario Bárcena; Xavier Boleda; José L Cañada; Niceto Gómez; Ana Mendoza; Isabel Vilaseca; Carles Llor
Journal:  Semergen       Date:  2015-05-23

Review 7.  [Recommendations for management of acute pharyngitis in adults].

Authors:  Josep M Cots; Juan-Ignacio Alós; Mario Bárcena; Xavier Boleda; José L Cañada; Niceto Gómez; Ana Mendoza; Isabel Vilaseca; Carles Llor
Journal:  Enferm Infecc Microbiol Clin       Date:  2015-04-11       Impact factor: 1.731

Review 8.  Recommendations for management of acute pharyngitis in adults.

Authors:  Josep M Cots; Juan-Ignacio Alós; Mario Bárcena; Xavier Boleda; José L Cañada; Niceto Gómez; Ana Mendoza; Isabel Vilaseca; Carles Llor
Journal:  Acta Otorrinolaringol Esp       Date:  2015-03-12

9.  Overdiagnosis paradigm: not suitable for decreasing the overuse of antibiotics.

Authors:  Gloria Cordoba; Carl Llor
Journal:  BMJ Evid Based Med       Date:  2019-02-11
  9 in total

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