Evidence map›Paper›PMID 28808076›Full record

ArticleThe British journal of general practice : the journal of the Royal College of General Practitioners2017

Influence of the duration of penicillin prescriptions on outcomes for acute sore throat in adults: the DESCARTE prospective cohort study in UK general practice.

Michael Moore, Beth Stuart, Fd Richard Hobbs, Chris C Butler, Alastair D Hay, John Campbell, Brendan C Delaney, Sue Broomfield, Paula Barratt, Kerenza Hood and 6 more

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Article in The British journal of general practice : the journal of the Royal College of General Practitioners, 2017. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 4 papers.

0numbers the graph read from it
0cells of the map it votes in
4citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from 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.

2 · The registry

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.

3 · Its place in the literature

Who cites it

4 citing papers in PubMed.

  1. Trial
  2. Trial
  3. Article
  4. Review
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

16 authors.

Michael MoorePrimary Care and Population Sciences Division, University of Southampton.
Beth StuartPrimary Care and Population Sciences Division, University of Southampton.
Fd Richard HobbsNuffield Department of Primary Care Health Sciences, University of Oxford.
Chris C ButlerNuffield Department of Primary Care Health Sciences, University of Oxford.
Alastair D HayCentre for Academic Primary Care, School of Social and Community Medicine, University of Bristol.
John CampbellUniversity of Exeter Medical School, Exeter.
Brendan C DelaneyDepartment of Surgery and Cancer, Imperial College, St Mary's Hospital, London.
Sue BroomfieldPrimary Care and Population Sciences Division, University of Southampton.
Paula BarrattPrimary Care and Population Sciences Division, University of Southampton.
Kerenza HoodSouth East Wales Trials Unit, Institute of Primary Care and Public Health, School of Medicine, Cardiff University.
Hazel EverittPrimary Care and Population Sciences Division, University of Southampton.
Mark MulleePrimary Care and Population Sciences Division, University of Southampton.
Ian WilliamsonPrimary Care and Population Sciences Division, University of Southampton.
David MantNuffield Department of Primary Care Health Sciences, University of Oxford.
Paul LittlePrimary Care and Population Sciences Division, University of Southampton.
DESCARTE investigators

Funding

Department of Health CDF-2009-02-10Department of Health RP-PG-0608-10018Medical Research Council G0500977
6 · The paper itself

Abstract

backgroundGuidelines recommend 10-day treatment courses for acute sore throat, but shorter courses may be used in practice.

aimTo determine whether antibiotic duration predicts adverse outcome of acute sore throat in adults in routine care. DESIGN AND

settingA secondary analysis of the DESCARTE (Decision rule for the Symptoms and Complications of Acute Red Throat in Everyday practice) prospective cohort study of 12 829 adults presenting in UK general practice with acute sore throat.

methodA brief clinical proforma was used to collect symptom severity and examination findings at presentation. Outcomes were collected by notes review, a sample also completed a symptom diary. The primary outcome was re-consultation with new/non-resolving symptoms within 1 month. The secondary outcome was 'global' poorer symptom control (longer than the median duration or higher than median severity).

resultsAntibiotics were prescribed for 62% (7872/12 677) of participants. The most commonly prescribed antibiotic was phenoxymethylpenicillin (76%, 5656/7474) and prescription durations were largely for 5 (20%), 7 (57%), or 10 (22%) days. Compared with 5-day courses, those receiving longer courses were less likely to re-consult with new or non-resolving symptoms (5 days 15.3%, 7 days 13.9%, 10 days 12.2%, 7-day course adjusted risk ratio (RR) 0.92 [95% confidence interval [CI] = 0.76 to 1.11] and 10-days RR 0.86 [95% CI = 0.59 to 1.23]) but these differences did not reach statistical significance.

conclusionIn adults prescribed antibiotics for sore throat, the authors cannot rule out a small advantage in terms of reduced re-consultation for a 10-day course of penicillin, but the effect is likely to be small.

Indexed as

Family PracticePharyngitisAdultAnti-Bacterial AgentsCohort StudiesFemaleHumansLong Term Adverse EffectsMaleMiddle AgedPenicillinsPractice Patterns, Physicians'Prospective StudiesQuality ImprovementSeverity of Illness IndexSymptom AssessmentAnti-Bacterial AgentsPenicillinsantibiotics, penicillincohort studiesdrug prescribingduration of prescribingoutcomessore throatsymptom control

Identifiers

PMID28808076
PMCPMC5569742

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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.