ArticleBMJ open2019
Antibiotic stewardship in skin infections: a cross-sectional analysis of early-career GP's management of impetigo.
Article in BMJ open, 2019. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 5 papers, 1 of them a synthesis that pooled it.
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Who cites it
5 citing papers in PubMed, 1 synthesis or guideline pooled it, 9 citations in OpenAlex.
- Early-career general practitioners' antibiotic prescribing for acute infections: a systematic review.The Journal of antimicrobial chemotherapy · 2024Pooled it
- Topical administration of mupirocin ointment and fusidic acid in bacterial infection-induced skin diseases.Postepy dermatologii i alergologii · 2025Article
- Prevalence and Predictors of Antibiotic Prescriptions at Primary Healthcare Facilities in the Dodoma Region, Central Tanzania: A Retrospective, Cross-Sectional Study.Antibiotics (Basel, Switzerland) · 2022Article
- Feasibility Study for a Randomised Controlled Trial for the Topical Treatment of Impetigo in Australian General Practice.Tropical medicine and infectious disease · 2021Article
- Prevalence and Associations of General Practice Registrars' Management of Impetigo: A Cross-Sectional Analysis From the Registrar Clinical Encounters in Training (ReCEnT) Study.Dermatology practical & conceptual · 2020Article
Corrections and comments
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Authors and funding
12 authors at 6 institutions in 1 country.
Funding
No grant is acknowledged in the PubMed record.
Abstract
objectiveTo establish the prevalence and associations of systemic antibiotic prescription for impetigo by early-career general practitioners (GPs) (GP registrars in their first 18 months in general practice).
designA cross-sectional analysis of data from the Registrar Clinical Encounters in Training (ReCEnT) study.
settingReCEnT is an ongoing multisite cohort study of Australian registrars' in-consultation clinical practice across five Australian states.
participantsRegistrars participating in ReCEnT from 2010 to 2017. OUTCOME MEASURES: Management of impetigo with systemic antibiotics.
results1741 registrars (response rate 96%) provided data from 384 731 problems identified in 246 434 consultations. Impetigo, on first presentation or follow-up, was managed in 930 (0.38%, 95% CI 0.35 to 0.40) consultations and comprised 0.24% (95% CI 0.23 to 0.26) of problems. 683 patients presented with a new diagnosis of impetigo of which 38/683 (5.6%) were not prescribed antibiotics; 239/683 (35.0%) were prescribed solely topical antibiotics; 306/683 (44.8%) solely systemic antibiotics and 100/683 (14.6%) both systemic and topical antibiotics. The most common systemic antibiotic prescribed was cephalexin (53.5%). Variables independently associated with prescription of systemic antibiotics were an inner regional (compared with major city) location (OR 1.82, 95% CI 1.06 to 3.13; p=0.028), seeking in-consultation information or advice (OR 2.17, 95% CI 1.47 to 3.23; p<0.001) and ordering pathology (OR 2.13, 95% CI 1.37 to 3.33; p=0.01).
conclusionsAustralian early-career GPs prescribe systemic antibiotics (the majority broad-spectrum) for a high proportion of initial impetigo presentations. Impetigo guidelines should clearly specify criteria for systemic antibiotic prescription and individual antibiotic choice. The role of non-antibiotic management and topical antiseptics needs to be explored further.
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