ArticleBJGP open2025
The effect of a GP's perception of a patient request for antibiotics on antibiotic prescribing for respiratory tract infections: secondary analysis of a point-prevalence audit survey in 18 European countries.
Article in BJGP open, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 8 papers.
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Who cites it
8 citing papers in PubMed.
- Is C-reactive protein the answer to antibiotics over-prescribing in primary care? A behavioural experiment in two European countries.JAC-antimicrobial resistance · 2026Article
- Between Patient Pressure and Professional Responsibility: Antibiotic Prescribing Practices in Primary Care.Healthcare (Basel, Switzerland) · 2026Article
- Antibiotic treatment for respiratory tract infections for migrants in Norway during the COVID-19 pandemic: a population-wide registry study.BMC primary care · 2026Observational
- Operationalizing the One Health approach in a conflict-affected setting: A scientometric review of policy foundations, systemic gaps, and future pathways in Ukraine.Veterinary world · 2026Article
- A feasibility study of the use of a patient leaflet for respiratory tract infection consultations in general practice in Ireland.Antimicrobial stewardship & healthcare epidemiology : ASHE · 2026Article
- The microbiome in mind: Reflections on antibiotic prescription in primary care.South African family practice : official journal of the South African Academy of Family Practice/Primary Care · 2025Article
- Article
- Antibiotic use for respiratory tract infections in nursing homes: a multicentre cross-sectional study.Frontiers in pharmacology · 2025Article
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Authors and funding
24 authors.
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No grant is acknowledged in the PubMed record.
Abstract
backgroundIllness severity, comorbidity, fever, age, and symptom duration influence antibiotic prescribing for respiratory tract infections (RTI). Non-medical determinants, such as patient expectations, also impact prescribing.
aimTo quantify the effect of a GP's perception of a patient request for antibiotics on antibiotic prescribing for RTI and investigate effect modification by medical determinants and country. DESIGN &
settingProspective audit of general practices in 18 European countries.
methodConsultation data were registered of 4982 patients presenting with acute cough and/or sore throat. A mixed-effect logistic regression model analysed the effect of GPs' perceptions of a patient request for antibiotics. Two-way interaction terms assessed effect modification. Relevant clinical findings were added to subgroups of lower RTI (LRTI), throat infection, and influenza-like-illness (ILI).
resultsA GP's perception of a request for antibiotics meant they were four times more likely to prescribe antibiotics (odds ratio [OR] 4.4, 95% confidence interval [CI] = 3.4 to 5.5). This effect varied by country: lower in Spain (OR 0.06), Ukraine (OR 0.15), and Greece (OR 0.22) compared with the lowest prescribing country. The effect was higher for ILI (OR 13.86, 95% CI = 5.5 to 35) and throat infection (OR 5.1, 95% CI = 3.1 to 8.4) than for LRTI (OR 2.9, 95% CI = 1.9 to 4.3). For ILI and LRTI, GPs were more likely to prescribe antibiotics with abnormal lung auscultation and/or increased or purulent sputum and for throat infection, with tonsillar exudate and/or swollen tonsils.
conclusionGPs' perceptions of an antibiotic request and specific clinical findings influence antibiotic prescribing. Incorporating exploration of patient expectations, point-of-care testing, and discussing watchful waiting into the decision-making process will benefit appropriate prescribing of antibiotics.
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