Reducing antibiotic prescribing for lower respiratory tract infections 6 years after a multifaceted intervention.

Abstract:

AIMS:Few studies have evaluated the long-term impact of interventions on antibiotic prescription for lower respiratory tract infections (LRTI). This study was aimed at evaluating the use of antibiotics prescribed for LRTIs by general practitioners (GP) who underwent a multifaceted intervention carried out 6 years earlier. METHODS:General practitioners who had completed two registrations in 2008 and 2009 were again invited to participate in a third audit-based study in 2015. A multifaceted intervention was held 1-3 months before the second registration. A new group of GPs with no previous training on the rational use of antibiotics were also invited to participate and acted as controls. Multilevel logistic regression was performed considering the prescription of antibiotics as the dependent variable. RESULTS:A total of 121 GPs of the 210 who underwent the intervention (57.6%) and 117 control GPs registered 4333 episodes of LRTIs. On adjustment for covariables, compared with the antibiotic prescription for LRTIs observed just after the intervention, antibiotic prescription slightly increased 6 years later among GPs who had undergone the intervention (OR 1.17, 95% CI 0.95-1.43), while control GPs prescribed significantly more antibiotics (OR 2.31, 95% CI 1.62-3.29). However, withholding antibiotic prescribing with C-reactive protein (CRP) values <10 mg/L was more frequently observed just after the intervention compared 6 years later (12.7% vs 32.2%; P < 0.01). CONCLUSIONS:Antibiotic prescribing for LRTIs remains low 6 years after an intervention, although GPs are less confident to withhold antibiotic therapy in patients with low CRP levels.

journal_name

Int J Clin Pract

authors

Molero JM,Moragas A,González López-Valcárcel B,Bjerrum L,Cots JM,Llor C

doi

10.1111/ijcp.13312

subject

Has Abstract

pub_date

2019-05-01 00:00:00

pages

e13312

issue

5

eissn

1368-5031

issn

1742-1241

journal_volume

73

pub_type

杂志文章,多中心研究
  • Efficacy of tadalafil in Egyptian and Turkish men with erectile dysfunction.

    abstract::A randomised, double-blind, parallel, placebo-controlled, 12-week study was carried out to evaluate the efficacy and safety of 20-mg tadalafil taken 'as needed' in a population of men with erectile dysfunction (ED) from Egypt and Turkey. One hundred and thirty-two patients were randomised in this study. Tadalafil was ...

    journal_title:International journal of clinical practice

    pub_type: 杂志文章,多中心研究,随机对照试验

    doi:10.1111/j.1742-1241.2006.00993.x

    authors: Saylan M,Khalaf I,Kadioglu A,Shoair KZ,Beheiry A,Wang WC,Kopernicky V,Esen A

    更新日期:2006-07-01 00:00:00

  • Effects of annual influenza vaccination on winter mortality in elderly people with chronic pulmonary disease.

    abstract:BACKGROUND:Although there is a general agreement for the recommendation of the influenza vaccine to persons with chronic obstructive pulmonary disease (COPD), the magnitude of clinical effectiveness and benefit from the annual vaccination is controversial. We assessed the effects of annual influenza vaccination on wint...

    journal_title:International journal of clinical practice

    pub_type: 杂志文章

    doi:10.1111/j.1742-1241.2007.01414.x

    authors: Vila-Córcoles A,Ochoa O,de Diego C,Valdivieso A,Herreros I,Bobé F,Alvarez M,Juárez M,Guinea I,Ansa X,Saún N

    更新日期:2008-01-01 00:00:00

  • The 'vasovagal effect' of nitrates: an under-recognised complication of nitrate use.

    abstract::Nitrates are useful drugs in cardiovascular medicine. They have a presumed vasovagal effect, which is a rare but often under-recognised complication that is partly caused by central inhibition of the sympathetic nervous system. However, no consistent variable associated with the presumed vasovagal effects following ni...

    journal_title:International journal of clinical practice

    pub_type: 杂志文章,评审

    doi:

    authors: Lydakis C,Chaudary AY,Lip GY

    更新日期:1998-09-01 00:00:00

  • Efficacy and safety of sildenafil citrate for the treatment of erectile dysfunction in men with cardiovascular disease.

    abstract::Men with cardiovascular disease (CVD) are more likely to have erectile dysfunction (ED) than the general population, as both conditions share risk factors and some drugs used to treat CVD may induce ED as a side-effect. This study was undertaken to assess the efficacy and safety of sildenafil citrate for the treatment...

    journal_title:International journal of clinical practice

    pub_type: 临床试验,杂志文章,多中心研究,随机对照试验

    doi:

    authors: Olsson AM,Persson CA,Swedish Sildenafil Investigators Group.

    更新日期:2001-04-01 00:00:00

  • A review of gastrointestinal foreign bodies.

    abstract::Gastrointestinal tract (GIT) foreign bodies represent a significant clinical problem in the Emergency Department, causing a high degree of financial burden, morbidity and mortality. A large variety of foreign bodies are accidentally ingested or inserted into the GIT in different age groups. This a retrospective review...

    journal_title:International journal of clinical practice

    pub_type: 杂志文章,评审

    doi:10.1111/j.1368-5031.2006.00709.x

    authors: Ayantunde AA,Oke T

    更新日期:2006-06-01 00:00:00

  • Illicit drug use and cardiometabolic disease risk: an analysis of 2005-2008 National Health and Nutrition Examination Survey data.

    abstract:PURPOSE:To explore the association between illicit drug use (IDU) and cardiometabolic disease risk factors (CDRF) in a nationally representative sample of adults. METHODS:The 2005-2008 National Health and Nutrition Examination Surveys data from 20- to 45-year-old adults (n = 8738) were utilised to analyze the relation...

    journal_title:International journal of clinical practice

    pub_type: 杂志文章

    doi:10.1111/ijcp.12189

    authors: Vidot DC,Arheart KL,Prado G,Bandstra ES,Messiah SE

    更新日期:2013-11-01 00:00:00

  • The impact of depression and somatic symptoms on treatment outcomes in patients with chronic prostatitis/chronic pelvic pain syndrome: a preliminary study in a naturalistic treatment setting.

    abstract:AIM:The aim of this study was to evaluate the impact of depression and somatic symptoms on treatment outcomes in Korean male patients with chronic prostatitis/chronic pelvic pain syndrome (CP/CPPS) attending a routine clinical practice. METHODS:This was a 12-week prospective observational study (n = 80). The Korean ve...

    journal_title:International journal of clinical practice

    pub_type: 杂志文章

    doi:10.1111/ijcp.12340

    authors: Koh JS,Ko HJ,Wang SM,Cho KJ,Kim JC,Lee SJ,Pae CU

    更新日期:2014-04-01 00:00:00

  • Prognostic implications of DPP-4 inhibitor vs. sulfonylurea use on top of metformin in a real world setting - results of the 1 year follow-up of the prospective DiaRegis registry.

    abstract:BACKGROUND:DPP-4 inhibitors (DPP4-I) have been shown to provide non-inferior glycaemic control compared with sulfonylureas (SU), but result in a reduction of body weight and a significantly lower risk of hypoglycaemia in patients with type 2 diabetes. We aimed to validate these results in a large real-world sample of p...

    journal_title:International journal of clinical practice

    pub_type: 杂志文章,多中心研究

    doi:10.1111/ijcp.12179

    authors: Gitt AK,Bramlage P,Binz C,Krekler M,Deeg E,Tschöpe D

    更新日期:2013-10-01 00:00:00

  • A patient with low free T4 and low thyroid-stimulating hormone without hypopituitarism.

    abstract::A 39-year-old entertainer was referred in November 2000 for suspected secondary hypothroidism found during a routine insurance check. Thyroid stimulating hormone (TSH) was 0.30 mIU/L (NR 0.47-4.68 mIU/L) and total T4 was 21.6 nmol/l (NR 57.9-154.4 nmol/l). She had enjoyed good past health and gave birth to a baby girl...

    journal_title:International journal of clinical practice

    pub_type: 杂志文章

    doi:10.1111/j.1742-1241.2004.00037.x

    authors: Chan WB,Chow CC,Cockram CS

    更新日期:2004-10-01 00:00:00

  • Hypertriglyceridaemia and NK cell lymphoma.

    abstract::This case report describes a patient who presented with pyrexia of unknown origin allied with hypertriglyceridaemia (16.2 mmol/l) but not hypercholesterolaemia (4.1 mmol/l). Investigations identified the cause of the pyrexia as an adult T-cell lymphoma of natural killer cell phenotype (CD3[+], CD7[+], anti-TCR alpha/b...

    journal_title:International journal of clinical practice

    pub_type: 杂志文章

    doi:

    authors: Suryanarayanan S,Wierzbicki AS,Carr R,Ritter JM

    更新日期:2003-12-01 00:00:00

  • Symptomatic hypercalcemia as presenting manifestation of lymphoma in a patient with acquired immunodeficiency syndrome.

    abstract::Hypercalcemia can be an uncommon manifestation of various infections and malignancies in HIV-positive patients. A case of severe symptomatic hypercalcemia as the first sign of non-Hodgkin's lymphoma in a patient found later to be HIV positive is presented. Differential diagnosis of calcium disorders should include tes...

    journal_title:International journal of clinical practice

    pub_type: 杂志文章

    doi:10.1111/j.1742-1241.2004.00055.x

    authors: Lydakis C,Karalis I,Anifantakis K,Tzortzakakis E,Apostolakis T

    更新日期:2004-11-01 00:00:00

  • Why do patients fail HIV therapy?

    abstract::Despite huge advances in terms of the impact of antiretroviral therapy on HIV-related morbidity and mortality patients continue to fail therapy. We discuss the reasons why failure occurs including primary or transmitted resistance, poor adherence, toxicity and drug potency. We performed a review of PubMed, Medline and...

    journal_title:International journal of clinical practice

    pub_type: 杂志文章,评审

    doi:10.1111/j.1742-1241.2007.01383.x

    authors: Waters L,Nelson M

    更新日期:2007-06-01 00:00:00

  • Chronic inflammation is negatively associated with prostate cancer and high-grade prostatic intraepithelial neoplasia on needle biopsy.

    abstract::Tissue inflammation has been linked to cancer in several disease models. We tested the association between chronic inflammation and prostate cancer (PCa), as well as high-grade prostatic intraepithelial neoplasia (HGPIN), in prostatic needle biopsy specimens. Tissues from 4526 men, who underwent systematic ultrasound-...

    journal_title:International journal of clinical practice

    pub_type: 杂志文章

    doi:10.1111/j.1742-1241.2006.00905.x

    authors: Karakiewicz PI,Benayoun S,Bégin LR,Duclos A,Valiquette L,McCormack M,Bénard F,Saad F,Perrotte P

    更新日期:2007-03-01 00:00:00

  • Ectopic eruption of maxillary permanent first molars: Predictive factors for self-corrected and impacted outcome.

    abstract:OBJECTIVE:The aim of this study was to describe the occurrence, angulation and mesialisation ratio of the ectopic eruption of the maxillary permanent first molar (PFM) and its correlation with the pathological resorption of maxillary primary second molar (PSM). METHODS:This retrospective study was performed using the ...

    journal_title:International journal of clinical practice

    pub_type: 杂志文章

    doi:10.1111/ijcp.13880

    authors: Caliskan S,Tuloglu N,Ozdemir C,Kizilaslan S,Bayrak S

    更新日期:2020-12-07 00:00:00

  • Proton pump inhibitors: update on their role in acid-related gastrointestinal diseases.

    abstract::Gastric acid is pathogenic in many gastrointestinal disorders, such as gastroesophageal reflux disease and peptic ulcer disease. Proton pump inhibitors (PPIs) are the antisecretory drugs of choice for serious acid-related conditions. Ample recent data exist to explicate virtually every aspect of the clinical managemen...

    journal_title:International journal of clinical practice

    pub_type: 杂志文章,评审

    doi:10.1111/j.1368-5031.2005.00517.x

    authors: Robinson M

    更新日期:2005-06-01 00:00:00

  • Initiation of hypertension treatment with a fixed-dose combination or its monocomponents -- does it really matter?

    abstract::Despite efforts to diagnose and treat hypertension effectively, the goal of lowering blood pressure (BP) levels is rarely achieved, as treatment is often initiated with a single antihypertensive agent. The aim of this study was to assess the safety and efficacy of a first-line fixed-dose combination treatment compared...

    journal_title:International journal of clinical practice

    pub_type: 杂志文章,多中心研究,随机对照试验

    doi:10.1111/j.1368-5031.2006.00841.x

    authors: Scholze J,Bida M,Hansen A,Juncken D,Rangoonwala B,Ritz A,Schnitker J,Dörffel Y

    更新日期:2006-03-01 00:00:00

  • The benefits and risks of DPP4-inhibitors vs. sulfonylureas for patients with type 2 diabetes: accumulated evidence from randomised controlled trial.

    abstract:AIM:To assess the efficacy and safety of dipeptidyl peptidase 4-inhibitors (DPP4-I) compared with sulphonylureas in adults with type 2 diabetes (T2D) mellitus. METHOD:Randomised controlled trials were collected from PubMed, EMBASE, Google Scholar and conference. The primary outcome was the change in HbA1c. Secondary o...

    journal_title:International journal of clinical practice

    pub_type: 杂志文章,meta分析,评审

    doi:10.1111/ijcp.12761

    authors: Zhou JB,Bai L,Wang Y,Yang JK

    更新日期:2016-02-01 00:00:00

  • Stroke prevention: missed opportunities?

    abstract::Identification and modification of risk factors can prevent strokes. Certain previously unidentified risk factors for stroke can become apparent following admission with acute stroke. The aim of the study was to investigate the prior capture, identification and management of modifiable risk factors for stroke in patie...

    journal_title:International journal of clinical practice

    pub_type: 杂志文章

    doi:

    authors: Gupta A,Thomas P

    更新日期:2002-06-01 00:00:00

  • Treating type 2 diabetes: how safe are current therapeutic agents?

    abstract::Sulphonylureas (SUs) and biguanides (metformin) are the current mainstays in the treatment of type 2 diabetes (T2DM) and represent the most commonly used oral hypoglycaemic agents (OHAs). In recent years, a variety of new OHAs have become available, including thiazolidinediones, glinides, alpha-glucosidase inhibitors,...

    journal_title:International journal of clinical practice

    pub_type: 杂志文章,评审

    doi:10.1111/j.1742-1241.2008.01980.x

    authors: Philippe J,Raccah D

    更新日期:2009-02-01 00:00:00

  • Helicobacter pylori eradication--comparison of three drug regimens and symptomatic assessment in duodenitis and antral gastritis.

    abstract::Helicobacter pylori (Hp) eradication in peptic ulcer disease is associated with a greatly reduced recurrence rate. The optimal drug regimen for HP eradication remains uncertain. It is also unclear if eradication of Hp in duodenitis and antral gastritis improves symptoms. The aims of this study were to compare the effi...

    journal_title:International journal of clinical practice

    pub_type: 临床试验,杂志文章,随机对照试验

    doi:

    authors: Tan WC,Hogan J,Purkayastha SK,Lombard M,Krasner N

    更新日期:1997-06-01 00:00:00

  • Tuberculous meningitis: a clinical and laboratory study of 20 patients in Qatar.

    abstract::Twenty cases of tuberculous meningitis were diagnosed at the Hamad Medical Corporation between 1990 and 1995. Most of the patients (90%) were expatriates. The most common presenting features were fever, headache, neck stiffness and altered mental status. Five patients were in stage 1 disease at the time of presentatio...

    journal_title:International journal of clinical practice

    pub_type: 杂志文章

    doi:

    authors: Alsoub H

    更新日期:1998-07-01 00:00:00

  • Bladder health across the life course.

    abstract::Influences on bladder health begin during infancy and continue throughout the lifespan. Bladder anatomy and physiology change as individuals age, and the risk and propensity for bladder conditions, including lower urinary tract symptoms, throughout life are related to factors specific to age, sex, and life events. Bla...

    journal_title:International journal of clinical practice

    pub_type: 杂志文章

    doi:10.1111/ijcp.12127

    authors: Ellsworth P,Marschall-Kehrel D,King S,Lukacz E

    更新日期:2013-05-01 00:00:00

  • Patient assessment of a novel therapeutic approach for the treatment of severe, chronic pain.

    abstract:BACKGROUND AND OBJECTIVES:Opioid-induced constipation can have a major negative impact on patients' quality of life. This randomised clinical trial evaluated patient assessment of the efficacy and tolerability of oral prolonged-release (PR) oxycodone when co-administered with oral naloxone PR. METHODS:Two hundred and ...

    journal_title:International journal of clinical practice

    pub_type: 杂志文章,多中心研究,随机对照试验

    doi:10.1111/j.1742-1241.2008.01820.x

    authors: Nadstawek J,Leyendecker P,Hopp M,Ruckes C,Wirz S,Fleischer W,Reimer K

    更新日期:2008-08-01 00:00:00

  • Chronic viral hepatitis.

    abstract::Both hepatitis B and hepatitis C are spread parenterally. Chronic hepatitis C is fast becoming the leading indication for liver transplantation. Most infected patients go on to develop chronic hepatitis, with approximately 20% developing liver cirrhosis or hepatocellular carcinoma after 20 years. Standard treatment no...

    journal_title:International journal of clinical practice

    pub_type: 杂志文章,评审

    doi:

    authors: Alexander G,Walsh K

    更新日期:2000-09-01 00:00:00

  • The biology behind the new therapies for SLE.

    abstract:BACKGROUND:Systemic lupus erythematosus (SLE) is a heterogenous disease with complex pathogenesis. AIM:In this review, we summarise recent progress in the understanding of SLE pathogenesis and discuss implications for the treatment of SLE patients using standard and experimental medications. CONCLUSIONS:The discovery...

    journal_title:International journal of clinical practice

    pub_type: 杂志文章,评审

    doi:10.1111/j.1742-1241.2007.01528.x

    authors: Ermann J,Bermas BL

    更新日期:2007-12-01 00:00:00

  • Patent foramen ovale and cryptogenic stroke: from studies to clinical practice: Position paper of the Italian Chapter, International Society Cardiovascular Ultrasound.

    abstract:BACKGROUND:Over the last two decades the interest on patent foramen ovale (PFO) as a cause of cardioembolism in cryptogenic stroke has tremendously increased, thanks to the availability of better techniques to diagnose cardiac right-to-left shunt by ultrasounds and of percutaneous means of PFO treatment with interventi...

    journal_title:International journal of clinical practice

    pub_type: 杂志文章,评审

    doi:10.1111/ijcp.12842

    authors: Savino K,Maiello M,Pelliccia F,Ambrosio G,Palmiero P

    更新日期:2016-08-01 00:00:00

  • Comparative effectiveness of cardioprotective drugs in elderly individuals with type 2 diabetes.

    abstract:AIMS:Although many elderly individuals suffer from type 2 diabetes, the effectiveness of cardioprotective drugs in primary prevention of cardiovascular events in clinical practice in this population has rarely been evaluated. We aimed to assess the effectiveness of, (i) angiotensin converting enzyme inhibitors or angio...

    journal_title:International journal of clinical practice

    pub_type: 杂志文章,多中心研究

    doi:10.1111/ijcp.12503

    authors: Sirois C,Moisan J,Poirier P,Grégoire JP

    更新日期:2015-03-01 00:00:00

  • Massage therapy for the treatment of depression: a systematic review.

    abstract:BACKGROUND:People with depressive disorders or subsyndromal symptoms of depression (SSD) often use complementary and alternative therapies, including massage therapy (MT). This systematic review evaluates the evidence, from randomised clinical trials (RCTs), for the effectiveness of multiple sessions of classical Europ...

    journal_title:International journal of clinical practice

    pub_type: 杂志文章,评审

    doi:10.1111/j.1742-1241.2007.01553.x

    authors: Coelho HF,Boddy K,Ernst E

    更新日期:2008-02-01 00:00:00

  • Management of advanced breast cancer with endocrine therapy: the role of the primary healthcare team.

    abstract::Of the 25,000 new cases of breast cancer annually in the UK, at least half will develop metastases at some time. Approximately one-third of these will be hormone-sensitive and thus suitable for endocrine manipulation. Such patients may live for several years. Care should be patient-centred and evidence-based, with pri...

    journal_title:International journal of clinical practice

    pub_type: 杂志文章,评审

    doi:

    authors: Theobald AJ

    更新日期:2000-12-01 00:00:00

  • Autologous tissue immediate breast reconstruction: desired but oncologically safe?

    abstract:BACKGROUND:There has been a dramatic increase in the incidence of immediate breast reconstruction after mastectomy for breast cancer over the past few decades and autologous tissue flaps are being used with increasing frequency. Concern has been expressed that these complex procedures may lead to a delay in the deliver...

    journal_title:International journal of clinical practice

    pub_type: 杂志文章,评审

    doi:10.1111/j.1742-1241.2009.02199.x

    authors: Lewis RS,Kontos M

    更新日期:2009-11-01 00:00:00