Evidence map›Paper›PMID 36720563›Full record

ArticleBJGP open2023

Re-examining advice to complete antibiotic courses: a qualitative study with clinicians and patients.

Aleksandra J Borek, George Edwards, Marta Santillo, Marta Wanat, Margaret Glogowska, Christopher C Butler, Ann Sarah Walker, Gail Hayward, Sarah Tonkin-Crine

Abstract read
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In one paragraph

Article in BJGP open, 2023. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 9 papers.

0numbers the graph read from it
0cells of the map it votes in
9citing 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

9 citing papers in PubMed.

  1. Review
  2. Ethics of Antibiotic Course Duration: Shorter is Better.The American journal of bioethics : AJOB · 2026
    Article
  3. Article
  4. Article
  5. Review
  6. Review
  7. Article
  8. Article
  9. Nitrofurantoin: what is the evidence for current UK guidance?The Journal of antimicrobial chemotherapy · 2023
    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

9 authors.

Aleksandra J BorekNuffield Department of Primary Care Health Sciences, University of Oxford, Oxford, UK aleksandra.borek@phc.ox.ac.uk.ORCID https://orcid.org/0000-0001-6029-5291
George EdwardsNuffield Department of Primary Care Health Sciences, University of Oxford, Oxford, UK.ORCID http://orcid.org/0000-0002-0048-4178
Marta SantilloNuffield Department of Primary Care Health Sciences, University of Oxford, Oxford, UK.
Marta WanatNuffield Department of Primary Care Health Sciences, University of Oxford, Oxford, UK.
Margaret GlogowskaNuffield Department of Primary Care Health Sciences, University of Oxford, Oxford, UK.ORCID https://orcid.org/0000-0001-8029-1052
Christopher C ButlerNuffield Department of Primary Care Health Sciences, University of Oxford, Oxford, UK.
Ann Sarah WalkerNational Institute for Health and Care Research (NIHR) Health Protection Research Unit in Healthcare Associated Infections and Antimicrobial Resistance, University of Oxford, Oxford, UK.
Gail HaywardNuffield Department of Primary Care Health Sciences, University of Oxford, Oxford, UK.
Sarah Tonkin-CrineNuffield Department of Primary Care Health Sciences, University of Oxford, Oxford, UK.ORCID https://orcid.org/0000-0003-4470-1151

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundAntibiotic treatment duration may be longer than sometimes needed. Stopping antibiotics early, rather than completing pre-set antibiotic courses, may help reduce unnecessary exposure to antibiotics and antimicrobial resistance (AMR).

aimTo identify clinicians' and patients' views on stopping antibiotics when better (SAWB) for urinary tract infections (UTIs), and to explore comparisons with other acute infections. DESIGN &

settingAn exploratory qualitative study with general practice clinicians and patients in England.

methodPrimary care clinicians and patients who had recent UTI experience were recruited in England. Remote one-to-one interviews with clinicians and patients, and one focus group with patients, were conducted. Data were audiorecorded, transcribed, and analysed thematically.

resultsEleven clinicians (seven GPs) and 19 patients (14 with experience of recurrent and/or chronic UTIs) were included. All participants considered SAWB unfamiliar and contradictory to well-known advice to complete antibiotic courses, but were interested in the evidence for risks and benefits of SAWB. Clinicians were amenable if evidence and guidelines supported it, whereas patients were more averse because of concerns about the risk of UTI recurrence and/or complications and AMR. Participants viewed SAWB as potentially more appropriate for longer antibiotic courses and other infections (with longer courses and lower risk of recurrence and/or complications). Participants stressed the need for unambiguous advice and SAWB as part of shared decision making and personalised advice.

conclusionPatients were less accepting of SAWB, whereas clinicians were more amenable to it. Patients and clinicians require good evidence that this novel approach to self-determining antibiotic duration is safe and beneficial. If evidence based, SAWB should be offered with an explanation of why the advice differs from the 'complete the course' instruction, and a clear indication of when exactly to stop antibiotics should be given.

Indexed as

antibiotic courseantimicrobial stewardshipcommunicable diseasesdrug resistance, microbialprimary health carequalitative research

Identifiers

PMID36720563
PMCPMC10354400

What OpenQuestion holds

Textmetadata
LicenceCC BY
Read underepoch 390

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.