RT Journal Article
SR Electronic
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
FD Royal College of General Practitioners
SP BJGPO.2021.0212
DO 10.3399/BJGPO.2021.0212
VO 6
IS 2
A1 van der Velden, Alike W
A1 van de Pol, Alma C
A1 Bongard, Emily
A1 Cianci, Daniela
A1 Aabenhus, Rune
A1 Balan, Anca
A1 Böhmer, Femke
A1 Bralić Lang, Valerija
A1 Bruno, Pascale
A1 Chlabicz, Slawomir
A1 Coenen, Samuel
A1 Colliers, Annelies
A1 García-Sangenís, Ana
A1 Ghazaryan, Hrachuhi
A1 Godycki-Ćwirko, Maciej
A1 Jensen, Siri
A1 Lionis, Christos
A1 van der Linde, Sanne R
A1 Malania, Lile
A1 Pauer, Jozsef
A1 Tomacinschii, Angela
A1 Vellinga, Akke
A1 Zastavnyy, Ihor
A1 Emmerich, Susanne
A1 Zerda, Adam
A1 Verheij, Theo J
A1 Goossens, Herman
A1 Butler, Christopher C
YR 2022
UL http://bjgpopen.org/content/6/2/BJGPO.2021.0212.abstract
AB 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.