Evidence map›Paper›PMID 35172735›Full record

ArticleBMC primary care2022

Factors associated with C-reactive protein testing when prescribing antibiotics in general practice: a register-based study.

Rikke Vognbjerg Sydenham, Malene Plejdrup Hansen, Ulrik Stenz Justesen, Line Bjørnskov Pedersen, Rune Munck Aabenhus, Sonja Wehberg, Dorte Ejg Jarbøl

Open access · goldAbstract read
In one paragraph

Article in BMC primary care, 2022. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 7 papers, 1 of them a synthesis that pooled it.

0numbers the graph read from it
0cells of the map it votes in
7citing papers in PubMed, 1 pooled it
0.5field-weighted citation impact, top 31% of its field
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

7 citing papers in PubMed, 1 synthesis or guideline pooled it, 5 citations in OpenAlex.

  1. Pooled it
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  3. Article
  4. Review
  5. Article
  6. Article
  7. 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

7 authors at 4 institutions in 1 country.

Rikke Vognbjerg SydenhamResearch Unit of General Practice, Institute of Public Health, University of Southern Denmark, JB Winsløws Vej 9A, 5000, Odense C, Denmark. rsydenham@health.sdu.dk.
Malene Plejdrup HansenCenter for General Practice at Aalborg University, Aalborg, Denmark.
Ulrik Stenz JustesenDepartment of Clinical Microbiology, Odense University Hospital, Odense, Denmark.
Line Bjørnskov PedersenResearch Unit of General Practice, Institute of Public Health, University of Southern Denmark, JB Winsløws Vej 9A, 5000, Odense C, Denmark.
Rune Munck AabenhusResearch Unit for General Practice, University of Copenhagen, Copenhagen, Denmark.
Sonja WehbergResearch Unit of General Practice, Institute of Public Health, University of Southern Denmark, JB Winsløws Vej 9A, 5000, Odense C, Denmark.
Dorte Ejg JarbølResearch Unit of General Practice, Institute of Public Health, University of Southern Denmark, JB Winsløws Vej 9A, 5000, Odense C, Denmark.
University of Southern Denmark · DKAalborg University · DKOdense University Hospital · DKUniversity of Copenhagen · DK

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundThe use of C-reactive protein (CRP) tests has been shown to safely reduce antibiotic prescribing for acute respiratory tract infections (RTIs). The aim of this study was to explore patient and clinical factors associated with the use of CRP testing when prescribing antibiotics recommended for RTIs.

methodsA nation-wide retrospective cross-sectional register-based study based on first redeemed antibiotic prescriptions issued to adults in Danish general practice between July 2015 and June 2017. Only antibiotics recommended for treatment of RTIs were included in the analysis (penicillin-V, amoxicillin, co-amoxicillin or roxithromycin/clarithromycin). Logistic regression models were used to estimate odds ratios for patient-related and clinical factors on performing a CRP test in relation to antibiotic prescribing.

resultsA total of 984,149 patients redeemed at least one antibiotic prescription during the two-year period. About half of these prescriptions (49.6%) had an RTI stated as the indication, and a CRP test was performed in relation to 45.2% of these scripts. Lower odds of having a CRP test performed in relation to an antibiotic prescription was found for patients aged 75 years and above (OR 0.82, 95CI 0.79-0.86), with a Charlson Comorbidity Index of more than one (OR 0.93, 95CI 0.91-0.95), unemployed or on disability pension (OR 0.84, 95CI 0.83-0.85) and immigrants (OR 0.91, 95CI 0.88-0.95) or descendants of immigrants (OR 0.90, 95CI 0.84-0.96). Living with a partner (OR 1.08, 95CI 1.07-1.10), being followed in practice for a chronic condition (OR 1.22, 95CI 1.18-1.26) and having CRP tests performed in the previous year (OR 1.78, 95CI 1.73-1.84) were associated with higher odds of CRP testing in relation to antibiotic prescribing.

conclusionsDifferences were observed in the use of CRP tests among subgroups of patients indicating that both sociodemographic factors and comorbidity influence the decision to use a CRP test in relation to antibiotic prescriptions in general practice. Potentially, this means that the use of CRP tests could be optimised to increase diagnostic certainty and further promote rational prescribing of antibiotics. The rationale behind the observed differences could be further explored in future qualitative studies.

Indexed as

General PracticeRespiratory Tract InfectionsAdultAmoxicillinAnti-Bacterial AgentsC-Reactive ProteinCross-Sectional StudiesHumansPractice Patterns, Physicians'Retrospective StudiesAmoxicillinAnti-Bacterial AgentsC-Reactive ProteinAnti-bacterial agentsC-reactive proteinDiagnostic testDrug prescriptionsGeneral practice

Identifiers

PMID35172735
PMCPMC8783519
OpenAlexW4207041028

What OpenQuestion holds

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LicenceCC BY
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Registered trials

None linked

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.