Trial reportThe British journal of general practice : the journal of the Royal College of General Practitioners2009
Effect of antibiotic prescribing strategies and an information leaflet on longer-term reconsultation for acute lower respiratory tract infection.
Trial report in The British journal of general practice : the journal of the Royal College of General Practitioners, 2009. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 26 papers, 4 of them syntheses that pooled it.
What it found
Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.
The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.
Who cites it
26 citing papers in PubMed, 4 syntheses or guidelines pooled it.
- Pooled it
- Immediate versus delayed versus no antibiotics for respiratory infections.The Cochrane database of systematic reviews · 2023Pooled it
- Delayed antibiotic prescriptions for respiratory infections.The Cochrane database of systematic reviews · 2017Pooled it
- Written information for patients (or parents of child patients) to reduce the use of antibiotics for acute upper respiratory tract infections in primary care.The Cochrane database of systematic reviews · 2016Pooled it
- Article
- How, why and when are delayed (back-up) antibiotic prescriptions used in primary care? A realist review integrating concepts of uncertainty in healthcare.BMC public health · 2024Review
- Changes in outpatient antibiotic prescribing for acute respiratory illnesses, 2011 to 2018.Antimicrobial stewardship & healthcare epidemiology : ASHE · 2021Article
- Article
- Primary care consultations after hospitalisation for pneumonia: a large population-based cohort study.The British journal of general practice : the journal of the Royal College of General Practitioners · 2021Article
- Awareness of Appropriate Antibiotic Use in Primary Care for Influenza-Like Illness: Evidence of Improvement from UK Population-Based Surveys.Antibiotics (Basel, Switzerland) · 2020Article
- Advances in optimizing the prescription of antibiotics in outpatient settings.BMJ (Clinical research ed.) · 2018Review
- Antibiotic use for acute respiratory tract infections (ARTI) in primary care; what factors affect prescribing and why is it important? A narrative review.Irish journal of medical science · 2018Review
- Article
- Impact of antibiotics for children presenting to general practice with cough on adverse outcomes: secondary analysis from a multicentre prospective cohort study.The British journal of general practice : the journal of the Royal College of General Practitioners · 2018Article
- Dyspnea in Children as a Symptom of Acute Respiratory Tract Infections and Antibiotic Prescribing.Open access Macedonian journal of medical sciences · 2018Article
- Article
- Antibiotic prescription strategies and adverse outcome for uncomplicated lower respiratory tract infections: prospective cough complication cohort (3C) study.BMJ (Clinical research ed.) · 2017Observational
- Parents' beliefs and knowledge about the management of acute otitis media: a qualitative study.BMC family practice · 2015Article
- Antibiotic Resistance: What are the Opportunities for Primary Care in Alleviating the Crisis?Frontiers in public health · 2015Review
- Using interactive family science shows to improve public knowledge on antibiotic resistance: does it work?PloS one · 2014Article
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
8 authors.
Funding
Abstract
backgroundLimited evidence suggests that delayed prescribing may influence future consultation behaviour.
aimTo assess the effects of antibiotic prescribing strategy on reconsultation in the year following presentation with acute lower respiratory tract infection (LRTI). DESIGN OF STUDY: Balanced factorial randomised trial.
settingPrimary care.
methodEight hundred and seven subjects, aged>or=3 years, had acute illness presenting with cough as the main symptom, plus at least one symptom or sign from sputum, chest pain, dyspnoea or wheeze. The subjects were randomised to one of three prescribing strategies (antibiotics, delayed antibiotic, no antibiotic) and a leaflet. Prior antibiotic use and reconsultation were assessed by medical record review.
resultsPatients who had been prescribed antibiotic for cough in the previous 2 years were much more likely to reconsult (incidence rate ratio [IRR]=2.55, 95% confidence interval [CI]=1.62 to 4.01) and use of a delayed prescription strategy is associated with reduced reconsultation in this group. In those with prior antibiotic exposure, there was a 34% reduction in consultation rate in the no antibiotic group (IRR=0.66, 0.30 to 1.44, P=0.295) and a 78% reduction for the delayed antibiotic group (IRR=0.22, 0.10 to 0.49, P<0.001) when compared with those given immediate antibiotics. This effect was not observed in patients who had not been prescribed antibiotics in the previous 2 years; there was no reduction in consultations in the no antibiotic group (IRR=1.23, 0.79 to 1.92, P=0.358) or the delayed antibiotic group (1.19, 0.78 to 1.80, P=0.426). There was an increase in consultation rate with an information leaflet (IRR=1.27, 0.86 to 1.87, P=0.229). Past attendance with cough, or past attendance with other respiratory illness and smoking, also predicted reconsultation with cough.
conclusionDelayed antibiotic prescribing for LRTI appears effective in modifying reconsultation behaviour, particularly in those with a prior history of antibiotic prescription for LRTI.
Indexed as
Identifiers
What 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.