ArticleThe British journal of general practice : the journal of the Royal College of General Practitioners2006
Antibiotic prescribing for acute cough: the effect of perceived patient demand.
Article in The British journal of general practice : the journal of the Royal College of General Practitioners, 2006. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 90 papers, 5 of them syntheses that pooled it.
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The trial behind it
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Who cites it
90 citing papers in PubMed, 5 syntheses or guidelines pooled it, 186 citations in OpenAlex.
- Systemic antibiotics for symptomatic apical periodontitis and acute apical abscess in adults.The Cochrane database of systematic reviews · 2024Pooled it
- Systemic antibiotics for symptomatic apical periodontitis and acute apical abscess in adults.The Cochrane database of systematic reviews · 2018Pooled it
- Systematic review of public-targeted communication interventions to improve antibiotic use.The Journal of antimicrobial chemotherapy · 2017Pooled it
- Systematic Review of Factors Associated with Antibiotic Prescribing for Respiratory Tract Infections.Antimicrobial agents and chemotherapy · 2016Pooled it
- Perceived difficulty and appropriateness of decision making by General Practitioners: a systematic review of scenario studies.BMC health services research · 2014Pooled it
- Echinacea reduces antibiotic usage in children through respiratory tract infection prevention: a randomized, blinded, controlled clinical trial.European journal of medical research · 2021Trial
- Reducing expectations for antibiotics in primary care: a randomised experiment to test the response to fear-based messages about antimicrobial resistance.BMC medicine · 2020Trial
- Effect of Bismuth Subsalicylate vs Placebo on Use of Antibiotics Among Adult Outpatients With Diarrhea in Pakistan: A Randomized Clinical Trial.JAMA network open · 2019Trial
- Provision of social norm feedback to high prescribers of antibiotics in general practice: a pragmatic national randomised controlled trial.Lancet (London, England) · 2016Trial
- Clinicians' views and experiences of interventions to enhance the quality of antibiotic prescribing for acute respiratory tract infections.Journal of general internal medicine · 2015Trial
- Trial
- Nudging guideline-concordant antibiotic prescribing: a randomized clinical trial.JAMA internal medicine · 2014Trial
- Amoxicillin for acute lower respiratory tract infection in primary care: subgroup analysis of potential high-risk groups.The British journal of general practice : the journal of the Royal College of General Practitioners · 2014Trial
- Effects of internet-based training on antibiotic prescribing rates for acute respiratory-tract infections: a multinational, cluster, randomised, factorial, controlled trial.Lancet (London, England) · 2013Trial
- Efficacy of anti-inflammatory or antibiotic treatment in patients with non-complicated acute bronchitis and discoloured sputum: randomised placebo controlled trial.BMJ (Clinical research ed.) · 2013Trial
- Enhancing the quality of antibiotic prescribing in primary care: qualitative evaluation of a blended learning intervention.BMC family practice · 2010Trial
- Effect of point of care testing for C reactive protein and training in communication skills on antibiotic use in lower respiratory tract infections: cluster randomised trial.BMJ (Clinical research ed.) · 2009Trial
- What is the role of quality circles in strategies to optimise antibiotic prescribing? A pragmatic cluster-randomised controlled trial in primary care.Quality & safety in health care · 2007Trial
- Point-of-care C-reactive protein testing and antibiotic prescribing for respiratory tract infections: a randomized controlled trial.Annals of family medicineTrial
- A Brief Shared Decision-Making Intervention for Acute Respiratory Infections on Antibiotic Dispensing Rates in Primary Care: A Cluster Randomized Trial.Annals of family medicineTrial
30 more citing papers are in PubMed but not listed here.
Corrections and comments
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Authors and funding
5 authors at 1 institution in 1 country.
Funding
No grant is acknowledged in the PubMed record.
Abstract
backgroundGPs decide whether or not to prescribe antibiotics for acute cough. Apart from clinical signs and symptoms, non-medical reasons influence this decision as well.
aimTo obtain a valid estimate of the effect of perceived patient demand. DESIGN OF STUDY: Secondary analysis of cluster randomised controlled trial data.
settingEighty-five Flemish GPs.
methodGPs completed a preprinted form with medical as well as non-medical information and their prescription for 20 consecutive adult patients consulting with acute cough in the periods February to April 2000 and 2001. The effect of perceived patient demand on antibiotic prescribing was estimated by performing alternating logistic regression analysis. A hierarchical backwards elimination procedure, described by Kleinbaum, was used.
resultsSeventy-two GPs participated, including 1448 patients eligible for analysis; 500 (34.5%) were prescribed an antibiotic and, according to the GP, 218 (15.1%) asked for an antibiotic. In cases of perceived patient demand antibiotics were prescribed significantly more often (odds ratio [OR] = 4.64, 95% confidence interval [CI] = 2.96 to 7.26). In the final model (n = 819; OR = 4.60, 2.59 to 8.17); Hosmer-Lemeshow goodness-of-fit P = 0.72), the effect of perceived patient demand for an antibiotic depended on the outcome of the lung auscultation. When patient demand was perceived, antibiotics were prescribed significantly more often only in the case of a normal lung auscultation or in the case of only one abnormal auscultatory finding (adjusted OR = 20.83, 95% CI = 8.86 to 48.99; adjusted OR = 4.79; 95% CI = 2.16 to 10.60, respectively).
conclusionsPerceived patient demand has a significant, independent and clinically relevant effect on antibiotic prescribing for acute cough with negative findings on the lung auscultation. Practice guidelines and interventions to optimise antibiotic prescribing have to take this effect into account.
Indexed as
Identifiers
16536958PMC1828261W2104420674What OpenQuestion holds
Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.