TY - JOUR
T1 - Low request of antibiotics from patients with respiratory tract infections in six countries
T2 - Results from the happy audit study
AU - Llor, Carl
AU - Bjerrum, Lars
AU - Strandberg, Eva Lena
AU - Radzeviciene, Ruta
AU - Reutskiy, Anatoliy
AU - Caballero, Lidia
PY - 2013/11/19
Y1 - 2013/11/19
N2 - A total of 59,535 patients with respiratory tract infections were registered in the Happy Audit project, an audit-based, before-and-after study conducted in primary care centres of six countries (Argentina, Denmark, Lithuania, Russia, Spain, and Sweden) in 2008 and 2009. An antibiotic was explicitly requested by the patient in 1,255 cases (2.1%), with a great variation across countries ranging from 0.4%-4.9%. Antibiotics were significantly more often prescribed to patients requesting them compared to those who did not (64% vs. 28%; p < 0.001). Patients with acute exacerbations of chronic bronchitis/chronic obstructive pulmonary disease were most likely to request antibiotics while those with common colds were least likely (3.9% vs. 1.2%, respectively). The presence of tonsillar exudates and dyspnoea were more commonly associated with a demand for antibiotics. Even though physicians very often perceive that patients demand an antibiotic, the results of this study clearly show that patients only request antibiotics in a low percentage of cases. Patients were most likely to request antibiotics when they had symptoms of lower respiratory tract infections and when they came with more severe symptoms. Furthermore, there were considerable differences between countries, suggesting that the different backgrounds and traditions largely explain this variability in patients' requests for antibiotics.
AB - A total of 59,535 patients with respiratory tract infections were registered in the Happy Audit project, an audit-based, before-and-after study conducted in primary care centres of six countries (Argentina, Denmark, Lithuania, Russia, Spain, and Sweden) in 2008 and 2009. An antibiotic was explicitly requested by the patient in 1,255 cases (2.1%), with a great variation across countries ranging from 0.4%-4.9%. Antibiotics were significantly more often prescribed to patients requesting them compared to those who did not (64% vs. 28%; p < 0.001). Patients with acute exacerbations of chronic bronchitis/chronic obstructive pulmonary disease were most likely to request antibiotics while those with common colds were least likely (3.9% vs. 1.2%, respectively). The presence of tonsillar exudates and dyspnoea were more commonly associated with a demand for antibiotics. Even though physicians very often perceive that patients demand an antibiotic, the results of this study clearly show that patients only request antibiotics in a low percentage of cases. Patients were most likely to request antibiotics when they had symptoms of lower respiratory tract infections and when they came with more severe symptoms. Furthermore, there were considerable differences between countries, suggesting that the different backgrounds and traditions largely explain this variability in patients' requests for antibiotics.
KW - Antibiotics
KW - Audit
KW - Demand
KW - Respiratory tract infections
UR - http://www.scopus.com/inward/record.url?scp=84933048978&partnerID=8YFLogxK
U2 - 10.3390/antibiotics2040477
DO - 10.3390/antibiotics2040477
M3 - Journal article
AN - SCOPUS:84933048978
SN - 2079-6382
VL - 2
SP - 477
EP - 484
JO - Antibiotics
JF - Antibiotics
IS - 4
ER -