Controversies in management: Should general practitioners perform diagnostic tests on patients before prescribing antibiotics?   For   Against

Kolmos, H J; Little, Paul

doi:10.1136/bmj.318.7186.799

Cited by 31 publications

(16 citation statements)

References 24 publications

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“…28,31 Thus, the utility of a clinical decision rule is not that it can perfectly target antibiotics (which is not strictly necessary) but that it can target antibiotics more appropriately than either empirical treatment or self-management, and that it is less likely to encourage belief in the importance of seeing the doctor than in routinely performing MSUs in all patients. 32 A clinical rule could also be potentially useful as part of telephone-or internet-based triage. Given the moderately low sensitivity of the rule, a reasonable approach would be to advise women who have less than two of the four features to return if their symptoms are not settling with conservative treatment, or, alternatively, to offer a backup (delayed) prescription of antibiotics, as used for respiratory infection.…”

Section: Implications For Clinical Practicementioning

confidence: 99%

Dipsticks and diagnostic algorithms in urinary tract infection: development and validation, randomised trial, economic analysis, observational cohort and qualitative study

Little¹,

Turner²,

Rumsby³

et al. 2009

Health Technol Assess

110

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Non-UK purchasers will have to pay a small fee for post and packing. For European countries the cost is £2 per monograph and for the rest of the world £3 per monograph.You can order HTA monographs from our Despatch Agents:-fax (with credit card or official purchase order) -post (with credit card or official purchase order or cheque) -phone during office hours (credit card only).Additionally the HTA website allows you either to pay securely by credit card or to print out your order and then post or fax it. NHS libraries can subscribe free of charge. Public libraries can subscribe at a very reduced cost of £100 for each volume (normally comprising 30-40 titles). The commercial subscription rate is £300 per volume. Please see our website for details. Subscriptions can be purchased only for the current or forthcoming volume. Contact details are as follows: Payment methods Paying by chequeIf you pay by cheque, the cheque must be in pounds sterling, made payable to Direct Mail Works Ltd and drawn on a bank with a UK address. Paying by credit cardThe following cards are accepted by phone, fax, post or via the website ordering pages: Delta, Eurocard, Mastercard, Solo, Switch and Visa. We advise against sending credit card details in a plain email. Paying by official purchase orderYou can post or fax these, but they must be from public bodies (i.e. NHS or universities) within the UK. We cannot at present accept purchase orders from commercial companies or from outside the UK. How do I get a copy of HTA on CD?Please use the form on the HTA website (www.hta.ac.uk/htacd.htm). Or contact Direct Mail Works (see contact details above) by email, post, fax or phone. HTA on CD is currently free of charge worldwide.The website also provides information about the HTA Programme and lists the membership of the various committees. HTA NIHR Health Technology Assessment ProgrammeT he Health Technology Assessment (HTA) Programme, part of the National Institute for Health Research (NIHR), was set up in 1993. It produces high-quality research information on the effectiveness, costs and broader impact of health technologies for those who use, manage and provide care in the NHS. 'Health technologies' are broadly defined as all interventions used to promote health, prevent and treat disease, and improve rehabilitation and long-term care. The research findings from the HTA Programme directly influence decision-making bodies such as the National Institute for Health and Clinical Excellence (NICE) and the National Screening Committee (NSC). HTA findings also help to improve the quality of clinical practice in the NHS indirectly in that they form a key component of the 'National Knowledge Service'. The HTA Programme is needs led in that it fills gaps in the evidence needed by the NHS. There are three routes to the start of projects. First is the commissioned route. Suggestions for research are actively sought from people working in the NHS, from the public and consumer groups and from professional bodies such as royal colleges and NHS trusts. Th...

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Section: Implications For Clinical Practicementioning

confidence: 99%

Dipsticks and diagnostic algorithms in urinary tract infection: development and validation, randomised trial, economic analysis, observational cohort and qualitative study

Little¹,

Turner²,

Rumsby³

et al. 2009

Health Technol Assess

110

View full text Add to dashboard Cite

show abstract

“…In Nordic countries, many GPs have direct access to point of care testing such as urine phase contrast microscopy, culture, and direct susceptibility testing to identify patients who need antibiotic treatment. [7][8][9] In the study by Gágyor and colleagues, only a third of patients with uncomplicated UTI needed antibiotics during the four weeks of follow-up, 5 so a strategy of delayed prescription for patients with light to moderate symptoms might also be a feasible strategy. We need trials of delayed prescriptions for UTI.…”

Section: Uncomplicated Urinary Tract Infection (Uti) Is the Most Commmentioning

confidence: 99%

Which treatment strategy for women with symptoms of urinary tract infection?

Bjerrum

Lindbæk²

2015

BMJ

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“…Bu infeksiyonların birçoğu bakteri dışı nedenlerle oluşmakta ve antibiyotik tedavisi gerektirmemektedir [28]. Hasta başı uygulanan testler veya elektronik raporlama ile daha hızlı sonuçlanan laboratuar testleri antimikrobiyal ajanların daha doğru bir şekilde kullanılmasına katkıda bulunabilir [29].…”

Section: Akılcı Antibiyotik Kullanımının Geliştirilmesiunclassified

Ayaktan takip ve tedavi edilen erişkin hastalarda akılcı antibiyotik kullanımı

Gözel¹

2012

CMJ

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Sistemik antibiyotiklerin önemli bir kısmı ayaktan başvuran ve poliklinik şartlarında takip ve tedavi edilen hastalarda kullanılmaktadır. Özellikle üst solunum yolu infeksiyonları gibi sıklıkla viral etkenler ile oluşan infeksiyonlarda antibiyotikler çeşitli nedenlerle yanlış kullanılmakta ve antimikrobiyal direnç gelişimine neden olmaktadır. Çoklu ilaç dirençli suşların oluşumu ve bu etkenlere bağlı gelişen infeksiyonlar günümüzde en önemli halk sağlığı problemlerinden birini oluşturmaktadır. Antimikrobiyal ilaçların akılcı ve uygun şekilde kullanımı bu ilaçlara karşı direnç gelişimini önlemede en önemli stratejilerden birini oluşturmaktadır.Anahtar sözcükler: Antibiyotik, akılcı antibiyotik kullanımı, antibiyotik direnci Abstract A significant part of the prescriptions of systemic antibiotics are made in patients who are treated in the outpatient setting. Although most outpatient respiratory tract infections that are caused primarily by viral pathogens do not require antimicrobial drug therapy, antibiotics are frequently prescribed. Inappropriate use of antibiotics is one of the most important factor affecting development of resistance to antimicrobial agents. The emergence of antibiotic resistant bacteria is a major public health problem throughout the world and rational use of antibiotics is therefore a very important. Strategy in preventin resistance against antibiotics.

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Controversies in management: Should general practitioners perform diagnostic tests on patients before prescribing antibiotics? For Against

Cited by 31 publications

References 24 publications

Dipsticks and diagnostic algorithms in urinary tract infection: development and validation, randomised trial, economic analysis, observational cohort and qualitative study

Dipsticks and diagnostic algorithms in urinary tract infection: development and validation, randomised trial, economic analysis, observational cohort and qualitative study

Which treatment strategy for women with symptoms of urinary tract infection?

Ayaktan takip ve tedavi edilen erişkin hastalarda akılcı antibiyotik kullanımı

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