Literature DB >> 28808075

Symptom response to antibiotic prescribing strategies in acute sore throat in adults: the DESCARTE prospective cohort study in UK general practice.

Michael Moore1, Beth Stuart1, Fd Richard Hobbs2, Chris C Butler2, Alastair D Hay3, John Campbell4, Brendan C Delaney5, Sue Broomfield1, Paula Barratt1, Kerenza Hood6, Hazel A Everitt1, Mark Mullee1, Ian Williamson1, David Mant2, Paul Little1.   

Abstract

BACKGROUND: A delayed or 'just in case' prescription has been identified as having potential to reduce antibiotic use in sore throat. AIM: To determine the symptomatic outcome of acute sore throat in adults according to antibiotic prescription strategy in routine care. DESIGN AND
SETTING: A secondary analysis of the DESCARTE (Decision rule for the Symptoms and Complications of Acute Red Throat in Everyday practice) prospective cohort study comprising adults aged ≥16 years presenting with acute sore throat (≤2 weeks' duration) managed with treatment as usual in primary care in the UK.
METHOD: A random sample of 2876 people from the full cohort were requested to complete a symptom diary. A brief clinical proforma was used to collect symptom severity and examination findings at presentation. Outcome details were collected by notes review and a detailed symptom diary. The primary outcome was poorer 'global' symptom control (defined as longer than the median duration or higher than median symptom severity). Analyses controlled for confounding by indication (propensity to prescribe antibiotics).
RESULTS: A total of 1629/2876 (57%) of those requested returned a symptom diary, of whom 1512 had information on prescribing strategy. The proportion with poorer global symptom control was greater in those not prescribed antibiotics 398/587 (68%) compared with those prescribed immediate antibiotics 441/728 (61%) or delayed antibiotic prescription 116/197 59%); adjusted risk ratio (RR) (95% confidence intervals [CI]): immediate RR 0.87 (95% CI = 0.70 to 0.96), P = 0.006; delayed RR 0.88 (95% CI = 0.78 to 1.00), P = 0.042.
CONCLUSION: In the routine care of adults with sore throat, a delayed antibiotic strategy confers similar symptomatic benefits to immediate antibiotics compared with no antibiotics. If a decision is made to prescribe an antibiotic, a delayed antibiotic strategy is likely to yield similar symptomatic benefit to immediate antibiotics. © British Journal of General Practice 2017.

Entities:  

Keywords:  antibiotics; cohort studies; delayed prescribing; drug prescribing; sore throat; symptom control

Mesh：

Substances：

Year:  2017        PMID： 28808075      PMCID： PMC5569743          DOI： 10.3399/bjgp17X692321

Source DB:  PubMed          Journal:  Br J Gen Pract        ISSN： 0960-1643            Impact factor:   5.386


  19 in total

1.  Desire for antibiotics and antibiotic prescribing for adults with upper respiratory tract infections.

Authors:  Jeffrey A Linder; Daniel E Singer
Journal:  J Gen Intern Med       Date:  2003-10       Impact factor: 5.128

2.  Pragmatic randomised controlled trial of two prescribing strategies for childhood acute otitis media.

Authors:  P Little; C Gould; I Williamson; M Moore; G Warner; J Dunleavey
Journal:  BMJ       Date:  2001-02-10

3.  Information leaflet and antibiotic prescribing strategies for acute lower respiratory tract infection: a randomized controlled trial.

Authors:  Paul Little; Kate Rumsby; Joanne Kelly; Louise Watson; Michael Moore; Gregory Warner; Tom Fahey; Ian Williamson
Journal:  JAMA       Date:  2005-06-22       Impact factor: 56.272

4.  Antibiotic prescribing and patient satisfaction in primary care in England: cross-sectional analysis of national patient survey data and prescribing data.

Authors:  Mark Ashworth; Patrick White; Hannah Jongsma; Peter Schofield; David Armstrong
Journal:  Br J Gen Pract       Date:  2015-12-06       Impact factor: 5.386

5.  Clinical score and rapid antigen detection test to guide antibiotic use for sore throats: randomised controlled trial of PRISM (primary care streptococcal management).

Authors:  Paul Little; F D Richard Hobbs; Michael Moore; David Mant; Ian Williamson; Cliodna McNulty; Ying Edith Cheng; Geraldine Leydon; Richard McManus; Joanne Kelly; Jane Barnett; Paul Glasziou; Mark Mullee
Journal:  BMJ       Date:  2013-10-10

6.  Continued high rates of antibiotic prescribing to adults with respiratory tract infection: survey of 568 UK general practices.

Authors:  Martin C Gulliford; Alex Dregan; Michael V Moore; Mark Ashworth; Tjeerd van Staa; Gerard McCann; Judith Charlton; Lucy Yardley; Paul Little; Lisa McDermott
Journal:  BMJ Open       Date:  2014-10-27       Impact factor: 2.692

7.  PRImary care Streptococcal Management (PRISM) study: in vitro study, diagnostic cohorts and a pragmatic adaptive randomised controlled trial with nested qualitative study and cost-effectiveness study.

Authors:  Paul Little; F D Richard Hobbs; Michael Moore; David Mant; Ian Williamson; Cliodna McNulty; Gemma Lasseter; M Y Edith Cheng; Geraldine Leydon; Lisa McDermott; David Turner; Rafael Pinedo-Villanueva; James Raftery; Paul Glasziou; Mark Mullee
Journal:  Health Technol Assess       Date:  2014-01       Impact factor: 4.014

8.  Antibiotic prescription strategies for acute sore throat: a prospective observational cohort study.

Authors:  Paul Little; Beth Stuart; F D Richard Hobbs; Chris C Butler; Alastair D Hay; Brendan Delaney; John Campbell; Sue Broomfield; Paula Barratt; Kerenza Hood; Hazel Everitt; Mark Mullee; Ian Williamson; David Mant; Michael Moore
Journal:  Lancet Infect Dis       Date:  2014-01-17       Impact factor: 25.071

9.  Predictors of suppurative complications for acute sore throat in primary care: prospective clinical cohort study.

Authors:  Paul Little; Beth Stuart; F D Richard Hobbs; Chris C Butler; Alastair D Hay; John Campbell; Brendan Delaney; Sue Broomfield; Paula Barratt; Kerenza Hood; Hazel Everitt; Mark Mullee; Ian Williamson; David Mant; Michael Moore
Journal:  BMJ       Date:  2013-11-25

10.  Safety of reduced antibiotic prescribing for self limiting respiratory tract infections in primary care: cohort study using electronic health records.

Authors:  Martin C Gulliford; Michael V Moore; Paul Little; Alastair D Hay; Robin Fox; A Toby Prevost; Dorota Juszczyk; Judith Charlton; Mark Ashworth
Journal:  BMJ       Date:  2016-07-04
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  5 in total

1.  Use of antibiotics for acute sore throat and tonsillitis in primary care.

Authors:  Christopher R Wilcox; Michael Moore; Paul Little
Journal:  Br J Gen Pract       Date:  2022-02-24       Impact factor: 5.386

2.  Influence of the duration of penicillin prescriptions on outcomes for acute sore throat in adults: the DESCARTE prospective cohort study in UK general practice.

Authors:  Michael Moore; Beth Stuart; Fd Richard Hobbs; Chris C Butler; Alastair D Hay; John Campbell; Brendan C Delaney; Sue Broomfield; Paula Barratt; Kerenza Hood; Hazel Everitt; Mark Mullee; Ian Williamson; David Mant; Paul Little
Journal:  Br J Gen Pract       Date:  2017-08-14       Impact factor: 5.386

Review 3.  Antibiotic use for acute respiratory tract infections (ARTI) in primary care; what factors affect prescribing and why is it important? A narrative review.

Authors:  Ray O'Connor; Jane O'Doherty; Andrew O'Regan; Colum Dunne
Journal:  Ir J Med Sci       Date:  2018-03-12       Impact factor: 1.568

4.  Delayed antibiotic prescribing for respiratory tract infections: individual patient data meta-analysis.

Authors:  Beth Stuart; Hilda Hounkpatin; Taeko Becque; Guiqing Yao; Shihua Zhu; Pablo Alonso-Coello; Attila Altiner; Bruce Arroll; Dankmar Böhning; Jennifer Bostock; Heiner C Bucher; Jennifer Chao; Mariam de la Poza; Nick Francis; David Gillespie; Alastair D Hay; Timothy Kenealy; Christin Löffler; David P McCormick; Gemma Mas-Dalmau; Laura Muñoz; Kirsty Samuel; Michael Moore; Paul Little
Journal:  BMJ       Date:  2021-04-28

5.  Implementation of the delayed antibiotic prescribing strategy. Prospective observation study in primary care.

Authors:  C Llor; A Moragas; J M Cots
Journal:  Rev Esp Quimioter       Date:  2022-02-03       Impact factor: 1.553
  5 in total

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