TY - JOUR T1 - Point-of-care testing, antibiotic prescribing, and prescribing confidence for respiratory tract infections in primary care: a prospective audit in 18 European countries JF - BJGP Open JO - BJGP Open DO - 10.3399/BJGPO.2021.0212 VL - 6 IS - 2 SP - BJGPO.2021.0212 AU - Alike W van der Velden AU - Alma C van de Pol AU - Emily Bongard AU - Daniela Cianci AU - Rune Aabenhus AU - Anca Balan AU - Femke Böhmer AU - Valerija Bralić Lang AU - Pascale Bruno AU - Slawomir Chlabicz AU - Samuel Coenen AU - Annelies Colliers AU - Ana García-Sangenís AU - Hrachuhi Ghazaryan AU - Maciej Godycki-Ćwirko AU - Siri Jensen AU - Christos Lionis AU - Sanne R van der Linde AU - Lile Malania AU - Jozsef Pauer AU - Angela Tomacinschii AU - Akke Vellinga AU - Ihor Zastavnyy AU - Susanne Emmerich AU - Adam Zerda AU - Theo J Verheij AU - Herman Goossens AU - Christopher C Butler Y1 - 2022/06/01 UR - http://bjgpopen.org/content/6/2/BJGPO.2021.0212.abstract N2 - Background Between-country differences have been described in antibiotic prescribing for respiratory tract infection (RTI) in primary care, but not yet for diagnostic testing procedures and prescribing confidence.Aim To describe between-country differences in RTI management, particularly diagnostic testing and antibiotic prescribing, and investigate which factors relate to antibiotic prescribing and GPs’ prescribing confidence.Design & setting Prospective audit in 18 European countries.Method An audit of GP-registered patient, clinical, and management characteristics for patients presenting with sore throat and/or lower RTI (n = 4982), and GPs' confidence in their antibiotic prescribing decision. Factors related to antibiotic prescribing and confidence were analysed using multi-level logistic regression.Results Antibiotic prescribing proportions varied considerably: <20% in four countries, and >40% in six countries. There was also considerable variation in point-of-care (POC) testing (0% in Croatia, Moldova, and Romania, and >65% in Denmark and Norway, mainly for C-reactive protein [CRP] and group A streptococcal [strep A] infection), and in laboratory or hospital-based testing (<3% in Hungary, the Netherlands, and Spain, and >30% in Croatia, Georgia, Greece, and Moldova, mainly chest X-ray and white blood cell counting). Antibiotic prescribing was related to illness severity, comorbidity, age, fever, and country, but not to having performed a POC test. In nearly 90% of consultations, GPs were confident in their antibiotic prescribing decision.Conclusion Despite high confidence in decisions about antibiotic prescribing, there is considerable variation in the primary care of RTI in European countries, with GPs prescribing antibiotics overall more often than is considered appropriate. POC testing may enhance the quality of antibiotic prescribing decisions if it can safely reverse decisions confidently made on clinical grounds alone to prescribe antibiotics. ER -