Point-of-care testing, antibiotic prescribing, and prescribing confidence for respiratory tract infections in primary care: a prospective audit in 18 European countries
Year: 2021
Type: article
Study design: Observational Study
Abstract: 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: = 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.
Source: BJGP Open
Authors: Alike W van der Velden, Alma C van de Pol, Emily Bongard, Daniela Cianci, Rune Aabenhus, Anca Balan, Femke Böhmer, Valerija Bralić Lang, Pascale Bruno, Slawomir Chlabicz, Samuel Coenen, Annelies Colliers, Ana García-Sangenís, Hrachuhi Ghazaryan, Maciej Godycki-Ćwirko, Siri Jensen, Christos Lionis, Sanne R van der Linde, Lile Malania, Jozsef Pauer, Angela Tomacinschii, Akke Vellinga, Ihor Zastavnyy, Susanne Emmerich, Adam Zerda, Theo J Verheij, Herman Goossens, Christopher C Butler
Institutions: University Medical Center Utrecht, Utrecht University, University of Oxford, University of Copenhagen, Universitätsmedizin Rostock, University of Zagreb, Andrija Stampar Teaching Institute of Public Health, Centre Hospitalier Universitaire de Nice, Medical University of Białystok, University of Antwerp, Institut Universitari d'Investigació en Atenció Primària Jordi Gol, Yerevan State Medical University, Medical University of Lodz, University of Oslo, University of Crete, National Center for Disease Control and Public Health, Georgian National Museum, Nicolae Testemițanu State University of Medicine and Pharmacy, Ollscoil na Gaillimhe – University of Galway, Abbott (Germany), Becton Dickinson (United States)
Language: English
Subfield: Applied Microbiology and Biotechnology
Field: Immunology and Microbiology
Domain: Life Sciences
Open Access status: gold
Estimated APC paid: $1,226
OpenAlex ID: W4200000460