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

VL - 2

SP - 477

EP - 484

JO - Antibiotics

JF - Antibiotics

SN - 2079-6382

IS - 4

ER -