| Title: |
The effect of a GP'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; HAG Infectieziekten; Infection & Immunity; JC onderzoeksprogramma Infectious Diseases |
| Publication Year: |
2025 |
| Subject Terms: |
Journal Article |
| 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 a GP's 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 of general practices 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' perceptions 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: A GP's perception of a request for antibiotics meant they were four times more likely to prescribe antibiotics (odds ratio [OR] 4.4, 95% confidence interval [CI] = 3.4 to 5.5). This effect varied by country: lower in Spain (OR 0.06), Ukraine (OR 0.15), and Greece (OR 0.22) compared with the lowest prescribing country. The effect was higher for ILI (OR 13.86, 95% CI = 5.5 to 35) and throat infection (OR 5.1, 95% CI = 3.1 to 8.4) than for LRTI (OR 2.9, 95% CI = 1.9 to 4.3). For ILI and LRTI, GPs were more likely to prescribe antibiotics with abnormal lung auscultation and/or increased or purulent sputum and for throat infection, with tonsillar exudate and/or swollen tonsils. CONCLUSION: GPs' perceptions 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 |
| File Description: |
application/pdf |
| Language: |
English |
| ISSN: |
2398-3795 |
| Relation: |
https://dspace.library.uu.nl/handle/1874/465410 |
| Availability: |
https://dspace.library.uu.nl/handle/1874/465410 |
| Rights: |
info:eu-repo/semantics/OpenAccess |
| Accession Number: |
edsbas.9FC5F06D |
| Database: |
BASE |