ArticlePloS one2017
Antibiotic prescribing for acute lower respiratory tract infections (LRTI) - guideline adherence in the German primary care setting: An analysis of routine data.
Article in PloS one, 2017. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 22 papers.
What it found
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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.
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Who cites it
22 citing papers in PubMed, 82 citations in OpenAlex.
- The complex phenomenon of dysrational antibiotics prescribing decisions in German primary healthcare: a qualitative interview study using dual process theory.Antimicrobial resistance and infection control · 2020Trial
- Sustainable reduction of antibiotic-induced antimicrobial resistance (ARena) in German ambulatory care: study protocol of a cluster randomised trial.Implementation science : IS · 2018Trial
- [Precision medicine in infectious diseases].Innere Medizin (Heidelberg, Germany) · 2024Review
- Exploring the association between phytopharmaceutical use and antibiotic prescriptions in upper respiratory infections: results from a German cohort study evaluating the impact of naturopathy qualifications of general practitioners using routine data.Frontiers in medicine · 2024Article
- The conceptualization of acute bronchitis in general practice - a fuzzy problem with consequences? A qualitative study in primary care.BMC primary care · 2023Article
- A qualitative investigation of paediatric intensive care staff attitudes towards the diagnosis of lower respiratory tract infection in the molecular diagnostics era.Intensive care medicine. Paediatric and neonatal · 2023Article
- Contextual factors influencing physicians' perception of antibiotic prescribing in primary care in Germany - a prospective observational study.BMC health services research · 2022Observational
- Assessing Reduction of Antibiotic Prescribing for Acute, Non-Complicated Infections in Primary Care in Germany: Multi-Step Outcome Evaluation in the Cluster-Randomized Trial ARena.Antibiotics (Basel, Switzerland) · 2021Article
- Antibiotic prescribing for acute, non-complicated infections in primary care in Germany: baseline assessment in the cluster randomized trial ARena.BMC infectious diseases · 2021Review
- Inhaled antibiotic-loaded polymeric nanoparticles for the management of lower respiratory tract infections.Nanoscale advances · 2021Review
- Evaluation of a multimodal intervention to promote rational antibiotic use in primary care.Antimicrobial resistance and infection control · 2021Article
- Procalcitonin Correlates With but Is Not Superior to Other Diagnostic Markers of Bacterial Pneumonia.American journal of clinical pathology · 2021Article
- Impact of guideline awareness on the counseling of patients with acute cough among general practitioners and pharmacy personnel.PloS one · 2021Article
- Effectiveness of Trainings of General Practitioners on Antibiotic Stewardship: Methods of a Pragmatic Quasi-Experimental Study in a Controlled Before-After Design in South-East-Lower Saxony, Germany (WASA).Frontiers in pharmacology · 2021Review
- Converting habits of antibiotic use for respiratory tract infections in German primary care (CHANGE-3) - process evaluation of a complex intervention.BMC family practice · 2020Article
- Applying Digital Information Delivery to Convert Habits of Antibiotic Use in Primary Care in Germany: Mixed-Methods Study.Journal of medical Internet research · 2020Article
- E-Health Tools to Improve Antibiotic Use and Resistances: A Systematic Review.Antibiotics (Basel, Switzerland) · 2020Review
- The Role of Microbiota in Preventing Multidrug-Resistant Bacterial Infections.Deutsches Arzteblatt international · 2019Review
- A pilot study of safety of sulfamethoxazole, trimethoprim and guaifenesin in pediatric and adult patients with acute bronchitis.BMC research notes · 2019Observational
- Update of a clinical prediction model for serious bacterial infections in preschool children by adding a host-protein-based assay: a diagnostic study.BMJ paediatrics open · 2019Article
Corrections and comments
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Authors and funding
4 authors at 2 institutions in 1 country.
Funding
No grant is acknowledged in the PubMed record.
Abstract
objectivesAntibiotic overprescribing in primary care has major impacts on the development of antibiotic resistance. The objective of this study is to provide insight in antibiotics prescriptions for patients suffering from cough, acute bronchitis or community acquired pneumonia in primary care.
methodsData from 2009 to 2013 of electronic health records of 12,880 patients in Germany were obtained from a research database. The prescription of antibiotics for acute lower respiratory tract infections was compared to the national S3 guideline cough from the German Society of General Practitioners and Family Medicine.
resultsAntibiotics were prescribed in 41% of consultations. General practitioners' decision of whether or not to prescribe an antibiotic was congruent with the guideline in 52% of consultations and the antibiotic choice congruence was 51% of antibiotic prescriptions. Hence, a congruent prescribing decision and a prescription of recommendation was found in only 25% of antibiotic prescriptions. Split by diagnosis we found that around three quarters of antibiotics prescribed for cough (73%) and acute bronchitis (78%) were not congruent to the guidelines. In contrast to that around one quarter of antibiotics prescribed for community acquired pneumonia (28%) were not congruent to the guidelines.
conclusionsOur results show that there is a big gap between guideline recommendation and actual prescribing, in the decision to prescribe and the choice of antibiotic agent. This gap could be closed by periodic quality circles on antibiotic prescribing for GPs.
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