| Title: |
The effect of a general practitioner’s perception of a patient request for antibiotics on antibiotic prescribing for respiratory tract infections : secondary analysis of a point prevalence audit survey in 18 European countries |
| Authors: |
Domen, Julie; Aabenhus, Rune; Balan, Anca; Bongard, Emily; Böhmer, Femke; Bralic Lang, Valerija; Bruno, Pascale; Chlabicz, Slawomir; Colliers, Annelies; Garcia-Sangenis, Ana; Ghazaryan, Hrachuhi; Kowalczyk, Anna; Jensen, Siri; Lionis, Christos; van der Linde, Tycho M.; Malania, Lile; Pauer, Jozsef; Tomacinschii, Angela; Vellinga, Akke; Zastavnyy, Ihor; Goossens, Herman; Butler, Christopher C.; van der Velden, Alike W.; Coenen, Samuel |
| Source: |
2398-3795 ; BJGP Open |
| Publication Year: |
2025 |
| Collection: |
IRUA - Institutional Repository van de Universiteit Antwerpen |
| Subject Terms: |
Human medicine |
| Description: |
Background Illness severity, comorbidity, fever, age and symptom duration influence antibiotic prescribing for respiratory tract infections (RTI). Non-medical determinants, such as patient expectations, also impact prescribing. Aim To quantify the effect of general practitioners’ (GPs’) perception of a patient request for antibiotics on antibiotic prescribing for RTI and investigate effect modification by medical determinants and country. Design & setting Prospective audit in 18 European countries. Method Consultation data were registered of 4982 patients presenting with acute cough and/or sore throat. A mixed-effect logistic regression model analysed the effect of GPs’ perception of a patient request for antibiotics. Two-way interaction terms assessed effect modification. Relevant clinical findings were added to subgroups of lower RTI (LRTI), throat infection, and influenza-like-illness (ILI). Results GPs who perceived a patient request for antibiotics were four times more likely to prescribe antibiotics (OR: 4.4, 95%CI: 3.4-5.5). This effect varied by country: lower in Spain (OR: 0.06), Ukraine (OR: 0.15), and Greece (OR: 0.22) compared to the lowest prescribing country. The effect was higher for ILI (OR: 13.86, 95%CI: 5.5-35) and throat infection (OR: 5.1, 95%CI: 3.1-8.4) than for LRTI (OR: 2.9, 95%CI: 1.9-4.3). For ILI and LRTI, GPs were more likely to prescribe antibiotics with abnormal lung auscultation and/or increased/purulent sputum and for throat infection, with tonsillar exudate and/or swollen tonsils. Conclusion GPs’ perception of an antibiotic request and specific clinical findings influence antibiotic prescribing. Incorporating exploration of patient expectations, point-of-care testing and discussing watchful waiting into the decision-making process will benefit appropriate prescribing of antibiotics. |
| Document Type: |
article in journal/newspaper |
| Language: |
English |
| Relation: |
info:eu-repo/grantAgreement/EC/h2020/820755 |
| Availability: |
https://hdl.handle.net/10067/2116950151162165141; https://repository.uantwerpen.be/docstore/d:irua:30059 |
| Rights: |
info:eu-repo/semantics/openAccess |
| Accession Number: |
edsbas.351E3DB2 |
| Database: |
BASE |