Clinical and haematological predictors of antibiotic prescribing for acute cough in adults in Swiss practices – an observational study

Streit, Sven; Frey, Peter; Singer, Sarah; Bollag, Ueli; Meli, Damian N.

doi:10.1186/s12875-015-0226-9

Cited by 11 publications

(15 citation statements)

References 31 publications

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“…Our study found that males were more likely to receive an antibiotic than females, similar to a study in Bangladesh [38] and in Ethiopia [41]. This is in sharp contrast with a study done by Smith et al [16], Anong et al [40] and Streit et al [42], where they reported that female gender was more significantly associated with antibiotic prescribing. This study showed that prescribing 3 to 4 medicines per encounter was significantly associated with antibiotic prescribing ( Table 5).…”

Section: Predictors Of Antibiotic Prescribingsupporting

confidence: 72%

Prescribing practices using WHO prescribing indicators and factors associated with antibiotic prescribing in six community pharmacies in Asmara, Eritrea: a cross-sectional study

Amaha

Weldemariam

Abdu

et al. 2019

Antimicrob Resist Infect Control

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Background: Antibiotics require more prudent prescribing, dispensing and administration than other medicines because these medicines are at a greater risk of antimicrobial resistance (AMR). Studying the current medicine use practices and factors affecting the prescribing of an antibiotic would help decision makers to draft policies that would enable a more rational use of medicines. Methods: A prospective, descriptive, and cross-sectional study was conducted to assess the current prescribing practices including antibiotics use in six community pharmacies in Asmara. A total of 600 encounters were reviewed using the WHO core prescribing indicators between May 5 and May 12, 2019 using stratified random sampling technique. Descriptive statistics and logistic regression were employed using IBM SPSS® (version 22). Results: The average number of medicines per prescription was 1.76 and 83.14% of the medicines were prescribed using generic names while 98.39% of the medicines were from the National Essential Medicines List (NEML). The percentage of prescriptions containing antibiotics was 53%. The number of encounters containing injections was 7.8%. Patient age, gender and number of medicines prescribed were significantly associated with antibiotic prescribing at bivariate and multivariable models. Subjects under the age of 15 were approximately three times more likely to be prescribed antibiotic compared to subjects whose age is 65 and above (Adjusted Odds Ratio (AOR): 2.93, 95%CI: 1.71-5). Similarly, males were more likely to be prescribed antibiotic than females (AOR: 1.57, 95%CI: 1.10-2.24). Subjects to whom three to four medicines prescribed were two times more likely to be prescribed an antibiotic compared to those who were to be prescribed one to two medicines per encounter (AOR: 2.17, 95%CI: 1.35-3.5). A one-unit increase in the number of medicines increased the odds of antibiotic prescribing increased by 2.02 units (COR: 2.02; 95%CI: 1.62-2.52). Conclusions: This study found that the percentage of antibiotics being prescribed at the community pharmacies in Asmara was 53% which deviated significantly from the WHO recommended values (20-26.8%). Furthermore, the percentage of encounters with an injection was 7.8% lower than the WHO value of 13.4-24.0%. Patients' age, gender and number of medicines were significantly associated with antibiotic prescribing.

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Section: Predictors Of Antibiotic Prescribingsupporting

confidence: 72%

Prescribing practices using WHO prescribing indicators and factors associated with antibiotic prescribing in six community pharmacies in Asmara, Eritrea: a cross-sectional study

Amaha

Weldemariam

Abdu

et al. 2019

Antimicrob Resist Infect Control

View full text Add to dashboard Cite

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“…Even though conclusive data from CRP testing in ambulatory care are lacking up to now [36], CRP testing is already broadly used in primary care [57]. PCT is not significantly influenced by comorbidities, patient demographics or treatment characteristics (e.g., chronic renal failure, chronic liver insufficiency, age, gender, or corticosteroid or antibiotic pretreatment), resulting in wide applicability of PCT levels to the typically heterogeneous GP patient population [58].…”

Section: Resultsmentioning

confidence: 99%

Management of patients with respiratory infections in primary care: procalcitonin, C-reactive protein or both?

Meili

Müller

Kulkarni³

et al. 2015

Expert Review of Respiratory Medicine

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Use of inflammatory biomarkers to guide antibiotic decisions has shown promising results in the risk-adapted management of respiratory tract infections, mainly in the inpatient setting. Several observational and interventional trials have investigated the benefits of procalcitonin (PCT) and C-reactive protein (CRP) testing in primary care. Both markers have shown promising results, although CRP is an inflammatory biomarker while PCT is more specific for bacterial infections. For CRP, point-of-care testing is widely established. Recently, sensitive point-of-care testing for PCT has also become available. A high-quality trial comparing these two markers for the management of patients in primary care is currently lacking. The aim of this paper is to review the existing literature investigating the use of PCT and CRP in primary care. The authors compare their performance for guiding antibiotic stewardship and analyze the cut-off values and endpoints to put these parameters into context in a low-acuity environment.

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“…A high WBC count might indicate a bacterial infection, and thus the likelihood of antibiotic prescription. Studies from Switzerland and China found that more antibiotic use among fever patients was assoiated with higher WBC count [22, 23]. …”

Section: Discussionmentioning

confidence: 99%

Patterns of medication use and factors associated with antibiotic use among adult fever patients at Singapore primary care clinics

Tun

Moorthy

Linster

et al. 2016

Antimicrob Resist Infect Control

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BackgroundAntimicrobial resistance is a public health problem of global importance. In Singapore, much focus has been given to antibiotic usage patterns in hospital settings. Data on antibiotic use in primary care is lacking. We describe antibiotic usage patterns and assess factors contributing to antibiotic usage among adults presenting with acute febrile illness (AFI) in primary care settings in Singapore.MethodsWe analyzed data from the Early Dengue infection and outcome study. Adults with AFI presenting at 5 Singapore polyclinics were included. We used multivariable logistic regression to assess demographic, clinical and laboratory factors associated with antibiotic usage among adults with AFI.ResultsBetween December 2007 and February 2013, 1884 adult AFI patients were enrolled. Overall, 16% of adult AFI patients reported antibiotic use. We observed a rise in the use of over-the-counter medications in late 2009 and a decrease in antibiotic use during 2010, possibly related to the outbreak of pandemic influenza A H1N1 virus. After adjusting for age, gender, polyclinic and year of enrolment, the following factors were associated with higher odds of antibiotic use: living in landed property (compared to public housing) (OR = 1.73; 95% CI: 1.06–2.80); body mass index (BMI) <18.5 (OR = 1.87; 95% CI: 1.19–2.93); elevated white blood cell (WBC) count (OR = 1.98; 95% CI: 1.42–2.78); and persistence of initial symptoms at 2–3 days follow-up with OR (95% CI) for categories of 1, 2, 3, and ≥4 persisting symptoms being 2.00 (1.38–2.92), 2.67 (1.80–3.97), 4.26 (2.73–6.64), and 2.79 (1.84–4.24) respectively.ConclusionsOur study provides insights on antibiotic usage among adult patients presenting to primary care clinics with febrile illness, and suggests that high socio-economic status, and risk factors of a severe illness, that is, low BMI and persistence of initial symptoms, are associated with higher antibiotic use. Further work to understand trends of antibiotic usage in both private and public primary care clinics, and factors that influence patient expectation and physician prescribing of antibiotics is important.

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Clinical and haematological predictors of antibiotic prescribing for acute cough in adults in Swiss practices – an observational study

Cited by 11 publications

References 31 publications

Prescribing practices using WHO prescribing indicators and factors associated with antibiotic prescribing in six community pharmacies in Asmara, Eritrea: a cross-sectional study

Prescribing practices using WHO prescribing indicators and factors associated with antibiotic prescribing in six community pharmacies in Asmara, Eritrea: a cross-sectional study

Management of patients with respiratory infections in primary care: procalcitonin, C-reactive protein or both?

Patterns of medication use and factors associated with antibiotic use among adult fever patients at Singapore primary care clinics

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