Symptom response to antibiotic prescribing strategies in acute sore throat in adults: the DESCARTE prospective cohort study in UK general practice
A delayed or 'just in case' prescription has been identified as having potential to reduce antibiotic use in sore throat. To determine the symptomatic outcome of acute sore throat in adults according to antibiotic prescription strategy in routine care. A secondary analysis of the DESCARTE...
Gespeichert in:
| Veröffentlicht in: | British journal of general practice 2017-09, Vol.67 (662), p.e634-e642 |
|---|---|
| Hauptverfasser: | , , , , , , , , , , , , , , |
| Format: | Artikel |
| Sprache: | eng |
| Schlagworte: | |
| Online-Zugang: | Volltext |
| Tags: |
Tag hinzufügen
Keine Tags, Fügen Sie den ersten Tag hinzu!
|
| container_end_page | e642 |
|---|---|
| container_issue | 662 |
| container_start_page | e634 |
| container_title | British journal of general practice |
| container_volume | 67 |
| creator | Moore, Michael Stuart, Beth Hobbs, Fd Richard Butler, Chris C Hay, Alastair D Campbell, John Delaney, Brendan C Broomfield, Sue Barratt, Paula Hood, Kerenza Everitt, Hazel A Mullee, Mark Williamson, Ian Mant, David Little, Paul |
| description | A delayed or 'just in case' prescription has been identified as having potential to reduce antibiotic use in sore throat.
To determine the symptomatic outcome of acute sore throat in adults according to antibiotic prescription strategy in routine care.
A secondary analysis of the DESCARTE (Decision rule for the Symptoms and Complications of Acute Red Throat in Everyday practice) prospective cohort study comprising adults aged ≥16 years presenting with acute sore throat (≤2 weeks' duration) managed with treatment as usual in primary care in the UK.
A random sample of 2876 people from the full cohort were requested to complete a symptom diary. A brief clinical proforma was used to collect symptom severity and examination findings at presentation. Outcome details were collected by notes review and a detailed symptom diary. The primary outcome was poorer 'global' symptom control (defined as longer than the median duration or higher than median symptom severity). Analyses controlled for confounding by indication (propensity to prescribe antibiotics).
A total of 1629/2876 (57%) of those requested returned a symptom diary, of whom 1512 had information on prescribing strategy. The proportion with poorer global symptom control was greater in those not prescribed antibiotics 398/587 (68%) compared with those prescribed immediate antibiotics 441/728 (61%) or delayed antibiotic prescription 116/197 59%); adjusted risk ratio (RR) (95% confidence intervals [CI]): immediate RR 0.87 (95% CI = 0.70 to 0.96),
= 0.006; delayed RR 0.88 (95% CI = 0.78 to 1.00),
= 0.042.
In the routine care of adults with sore throat, a delayed antibiotic strategy confers similar symptomatic benefits to immediate antibiotics compared with no antibiotics. If a decision is made to prescribe an antibiotic, a delayed antibiotic strategy is likely to yield similar symptomatic benefit to immediate antibiotics. |
| doi_str_mv | 10.3399/bjgp17X692321 |
| format | Article |
| fullrecord | <record><control><sourceid>proquest_pubme</sourceid><recordid>TN_cdi_pubmedcentral_primary_oai_pubmedcentral_nih_gov_5569743</recordid><sourceformat>XML</sourceformat><sourcesystem>PC</sourcesystem><sourcerecordid>1929103824</sourcerecordid><originalsourceid>FETCH-LOGICAL-c3021-f511a3f26d0a6a9dcb1a458b326f37798b4d19a66302fb8e8f5d351964ff991d3</originalsourceid><addsrcrecordid>eNpVkU9v1DAQxS0EokvhyBX5yCXUfxLH5oBUbReKqIREW4mb5TjjrKskDrZTab8GnxiXloqeLD__5o1nHkJvKfnAuVIn3c2w0PanUIwz-gxtaN3KqmE1e442RAlSUVHzI_QqpRtCGBOUvERHTEoiSdts0O_Lw7TkMOEIaQlzApwDNnP2nQ_ZW7wU3cZymweccjQZBg8J-xkbu2bAKcRSso_B5L9iv445fSwK4LPd5fb0x9WueIS0gM3-FrAN-xBzsVr7w13B9Tc8wAzRjAUzhbHwGr1wZkzw5uE8Rtefd1fb8-ri-5ev29OLynLCaOUaSg13TPTECKN621FTN7LjTDjetkp2dU-VEaLQrpMgXdPzhipRO6cU7fkx-nTvu6zdBL2Fucw36iX6ycSDDsbrpy-z3-sh3OqmEaqteTF4_2AQw68VUtaTTxbG0cwQ1qSpYooSLlld0OoetWUXKYJ7bEOJvstRP8mx8O_-_9sj_S84_geFtp0t</addsrcrecordid><sourcetype>Open Access Repository</sourcetype><iscdi>true</iscdi><recordtype>article</recordtype><pqid>1929103824</pqid></control><display><type>article</type><title>Symptom response to antibiotic prescribing strategies in acute sore throat in adults: the DESCARTE prospective cohort study in UK general practice</title><source>MEDLINE</source><source>PubMed Central</source><source>Alma/SFX Local Collection</source><creator>Moore, Michael ; Stuart, Beth ; Hobbs, Fd Richard ; Butler, Chris C ; Hay, Alastair D ; Campbell, John ; Delaney, Brendan C ; Broomfield, Sue ; Barratt, Paula ; Hood, Kerenza ; Everitt, Hazel A ; Mullee, Mark ; Williamson, Ian ; Mant, David ; Little, Paul</creator><creatorcontrib>Moore, Michael ; Stuart, Beth ; Hobbs, Fd Richard ; Butler, Chris C ; Hay, Alastair D ; Campbell, John ; Delaney, Brendan C ; Broomfield, Sue ; Barratt, Paula ; Hood, Kerenza ; Everitt, Hazel A ; Mullee, Mark ; Williamson, Ian ; Mant, David ; Little, Paul ; DESCARTE investigators</creatorcontrib><description>A delayed or 'just in case' prescription has been identified as having potential to reduce antibiotic use in sore throat.
To determine the symptomatic outcome of acute sore throat in adults according to antibiotic prescription strategy in routine care.
A secondary analysis of the DESCARTE (Decision rule for the Symptoms and Complications of Acute Red Throat in Everyday practice) prospective cohort study comprising adults aged ≥16 years presenting with acute sore throat (≤2 weeks' duration) managed with treatment as usual in primary care in the UK.
A random sample of 2876 people from the full cohort were requested to complete a symptom diary. A brief clinical proforma was used to collect symptom severity and examination findings at presentation. Outcome details were collected by notes review and a detailed symptom diary. The primary outcome was poorer 'global' symptom control (defined as longer than the median duration or higher than median symptom severity). Analyses controlled for confounding by indication (propensity to prescribe antibiotics).
A total of 1629/2876 (57%) of those requested returned a symptom diary, of whom 1512 had information on prescribing strategy. The proportion with poorer global symptom control was greater in those not prescribed antibiotics 398/587 (68%) compared with those prescribed immediate antibiotics 441/728 (61%) or delayed antibiotic prescription 116/197 59%); adjusted risk ratio (RR) (95% confidence intervals [CI]): immediate RR 0.87 (95% CI = 0.70 to 0.96),
= 0.006; delayed RR 0.88 (95% CI = 0.78 to 1.00),
= 0.042.
In the routine care of adults with sore throat, a delayed antibiotic strategy confers similar symptomatic benefits to immediate antibiotics compared with no antibiotics. If a decision is made to prescribe an antibiotic, a delayed antibiotic strategy is likely to yield similar symptomatic benefit to immediate antibiotics.</description><identifier>ISSN: 0960-1643</identifier><identifier>EISSN: 1478-5242</identifier><identifier>DOI: 10.3399/bjgp17X692321</identifier><identifier>PMID: 28808075</identifier><language>eng</language><publisher>England: Royal College of General Practitioners</publisher><subject>Adult ; Anti-Bacterial Agents - administration & dosage ; Cohort Studies ; Family Practice - methods ; Family Practice - standards ; Female ; Humans ; Male ; Middle Aged ; Patient Reported Outcome Measures ; Pharyngitis - diagnosis ; Pharyngitis - drug therapy ; Pharyngitis - epidemiology ; Practice Patterns, Physicians' - standards ; Prospective Studies ; Quality Improvement ; Symptom Assessment - methods ; Symptom Assessment - statistics & numerical data ; Time-to-Treatment - statistics & numerical data ; United Kingdom - epidemiology</subject><ispartof>British journal of general practice, 2017-09, Vol.67 (662), p.e634-e642</ispartof><rights>British Journal of General Practice 2017.</rights><rights>British Journal of General Practice 2017 2017</rights><lds50>peer_reviewed</lds50><oa>free_for_read</oa><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c3021-f511a3f26d0a6a9dcb1a458b326f37798b4d19a66302fb8e8f5d351964ff991d3</citedby><cites>FETCH-LOGICAL-c3021-f511a3f26d0a6a9dcb1a458b326f37798b4d19a66302fb8e8f5d351964ff991d3</cites></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktopdf>$$Uhttps://www.ncbi.nlm.nih.gov/pmc/articles/PMC5569743/pdf/$$EPDF$$P50$$Gpubmedcentral$$H</linktopdf><linktohtml>$$Uhttps://www.ncbi.nlm.nih.gov/pmc/articles/PMC5569743/$$EHTML$$P50$$Gpubmedcentral$$H</linktohtml><link.rule.ids>230,314,723,776,780,881,27901,27902,53766,53768</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/28808075$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Moore, Michael</creatorcontrib><creatorcontrib>Stuart, Beth</creatorcontrib><creatorcontrib>Hobbs, Fd Richard</creatorcontrib><creatorcontrib>Butler, Chris C</creatorcontrib><creatorcontrib>Hay, Alastair D</creatorcontrib><creatorcontrib>Campbell, John</creatorcontrib><creatorcontrib>Delaney, Brendan C</creatorcontrib><creatorcontrib>Broomfield, Sue</creatorcontrib><creatorcontrib>Barratt, Paula</creatorcontrib><creatorcontrib>Hood, Kerenza</creatorcontrib><creatorcontrib>Everitt, Hazel A</creatorcontrib><creatorcontrib>Mullee, Mark</creatorcontrib><creatorcontrib>Williamson, Ian</creatorcontrib><creatorcontrib>Mant, David</creatorcontrib><creatorcontrib>Little, Paul</creatorcontrib><creatorcontrib>DESCARTE investigators</creatorcontrib><title>Symptom response to antibiotic prescribing strategies in acute sore throat in adults: the DESCARTE prospective cohort study in UK general practice</title><title>British journal of general practice</title><addtitle>Br J Gen Pract</addtitle><description>A delayed or 'just in case' prescription has been identified as having potential to reduce antibiotic use in sore throat.
To determine the symptomatic outcome of acute sore throat in adults according to antibiotic prescription strategy in routine care.
A secondary analysis of the DESCARTE (Decision rule for the Symptoms and Complications of Acute Red Throat in Everyday practice) prospective cohort study comprising adults aged ≥16 years presenting with acute sore throat (≤2 weeks' duration) managed with treatment as usual in primary care in the UK.
A random sample of 2876 people from the full cohort were requested to complete a symptom diary. A brief clinical proforma was used to collect symptom severity and examination findings at presentation. Outcome details were collected by notes review and a detailed symptom diary. The primary outcome was poorer 'global' symptom control (defined as longer than the median duration or higher than median symptom severity). Analyses controlled for confounding by indication (propensity to prescribe antibiotics).
A total of 1629/2876 (57%) of those requested returned a symptom diary, of whom 1512 had information on prescribing strategy. The proportion with poorer global symptom control was greater in those not prescribed antibiotics 398/587 (68%) compared with those prescribed immediate antibiotics 441/728 (61%) or delayed antibiotic prescription 116/197 59%); adjusted risk ratio (RR) (95% confidence intervals [CI]): immediate RR 0.87 (95% CI = 0.70 to 0.96),
= 0.006; delayed RR 0.88 (95% CI = 0.78 to 1.00),
= 0.042.
In the routine care of adults with sore throat, a delayed antibiotic strategy confers similar symptomatic benefits to immediate antibiotics compared with no antibiotics. If a decision is made to prescribe an antibiotic, a delayed antibiotic strategy is likely to yield similar symptomatic benefit to immediate antibiotics.</description><subject>Adult</subject><subject>Anti-Bacterial Agents - administration & dosage</subject><subject>Cohort Studies</subject><subject>Family Practice - methods</subject><subject>Family Practice - standards</subject><subject>Female</subject><subject>Humans</subject><subject>Male</subject><subject>Middle Aged</subject><subject>Patient Reported Outcome Measures</subject><subject>Pharyngitis - diagnosis</subject><subject>Pharyngitis - drug therapy</subject><subject>Pharyngitis - epidemiology</subject><subject>Practice Patterns, Physicians' - standards</subject><subject>Prospective Studies</subject><subject>Quality Improvement</subject><subject>Symptom Assessment - methods</subject><subject>Symptom Assessment - statistics & numerical data</subject><subject>Time-to-Treatment - statistics & numerical data</subject><subject>United Kingdom - epidemiology</subject><issn>0960-1643</issn><issn>1478-5242</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2017</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><recordid>eNpVkU9v1DAQxS0EokvhyBX5yCXUfxLH5oBUbReKqIREW4mb5TjjrKskDrZTab8GnxiXloqeLD__5o1nHkJvKfnAuVIn3c2w0PanUIwz-gxtaN3KqmE1e442RAlSUVHzI_QqpRtCGBOUvERHTEoiSdts0O_Lw7TkMOEIaQlzApwDNnP2nQ_ZW7wU3cZymweccjQZBg8J-xkbu2bAKcRSso_B5L9iv445fSwK4LPd5fb0x9WueIS0gM3-FrAN-xBzsVr7w13B9Tc8wAzRjAUzhbHwGr1wZkzw5uE8Rtefd1fb8-ri-5ev29OLynLCaOUaSg13TPTECKN621FTN7LjTDjetkp2dU-VEaLQrpMgXdPzhipRO6cU7fkx-nTvu6zdBL2Fucw36iX6ycSDDsbrpy-z3-sh3OqmEaqteTF4_2AQw68VUtaTTxbG0cwQ1qSpYooSLlld0OoetWUXKYJ7bEOJvstRP8mx8O_-_9sj_S84_geFtp0t</recordid><startdate>20170901</startdate><enddate>20170901</enddate><creator>Moore, Michael</creator><creator>Stuart, Beth</creator><creator>Hobbs, Fd Richard</creator><creator>Butler, Chris C</creator><creator>Hay, Alastair D</creator><creator>Campbell, John</creator><creator>Delaney, Brendan C</creator><creator>Broomfield, Sue</creator><creator>Barratt, Paula</creator><creator>Hood, Kerenza</creator><creator>Everitt, Hazel A</creator><creator>Mullee, Mark</creator><creator>Williamson, Ian</creator><creator>Mant, David</creator><creator>Little, Paul</creator><general>Royal College of General Practitioners</general><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>7X8</scope><scope>5PM</scope></search><sort><creationdate>20170901</creationdate><title>Symptom response to antibiotic prescribing strategies in acute sore throat in adults: the DESCARTE prospective cohort study in UK general practice</title><author>Moore, Michael ; Stuart, Beth ; Hobbs, Fd Richard ; Butler, Chris C ; Hay, Alastair D ; Campbell, John ; Delaney, Brendan C ; Broomfield, Sue ; Barratt, Paula ; Hood, Kerenza ; Everitt, Hazel A ; Mullee, Mark ; Williamson, Ian ; Mant, David ; Little, Paul</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c3021-f511a3f26d0a6a9dcb1a458b326f37798b4d19a66302fb8e8f5d351964ff991d3</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2017</creationdate><topic>Adult</topic><topic>Anti-Bacterial Agents - administration & dosage</topic><topic>Cohort Studies</topic><topic>Family Practice - methods</topic><topic>Family Practice - standards</topic><topic>Female</topic><topic>Humans</topic><topic>Male</topic><topic>Middle Aged</topic><topic>Patient Reported Outcome Measures</topic><topic>Pharyngitis - diagnosis</topic><topic>Pharyngitis - drug therapy</topic><topic>Pharyngitis - epidemiology</topic><topic>Practice Patterns, Physicians' - standards</topic><topic>Prospective Studies</topic><topic>Quality Improvement</topic><topic>Symptom Assessment - methods</topic><topic>Symptom Assessment - statistics & numerical data</topic><topic>Time-to-Treatment - statistics & numerical data</topic><topic>United Kingdom - epidemiology</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Moore, Michael</creatorcontrib><creatorcontrib>Stuart, Beth</creatorcontrib><creatorcontrib>Hobbs, Fd Richard</creatorcontrib><creatorcontrib>Butler, Chris C</creatorcontrib><creatorcontrib>Hay, Alastair D</creatorcontrib><creatorcontrib>Campbell, John</creatorcontrib><creatorcontrib>Delaney, Brendan C</creatorcontrib><creatorcontrib>Broomfield, Sue</creatorcontrib><creatorcontrib>Barratt, Paula</creatorcontrib><creatorcontrib>Hood, Kerenza</creatorcontrib><creatorcontrib>Everitt, Hazel A</creatorcontrib><creatorcontrib>Mullee, Mark</creatorcontrib><creatorcontrib>Williamson, Ian</creatorcontrib><creatorcontrib>Mant, David</creatorcontrib><creatorcontrib>Little, Paul</creatorcontrib><creatorcontrib>DESCARTE investigators</creatorcontrib><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>MEDLINE - Academic</collection><collection>PubMed Central (Full Participant titles)</collection><jtitle>British journal of general practice</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Moore, Michael</au><au>Stuart, Beth</au><au>Hobbs, Fd Richard</au><au>Butler, Chris C</au><au>Hay, Alastair D</au><au>Campbell, John</au><au>Delaney, Brendan C</au><au>Broomfield, Sue</au><au>Barratt, Paula</au><au>Hood, Kerenza</au><au>Everitt, Hazel A</au><au>Mullee, Mark</au><au>Williamson, Ian</au><au>Mant, David</au><au>Little, Paul</au><aucorp>DESCARTE investigators</aucorp><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Symptom response to antibiotic prescribing strategies in acute sore throat in adults: the DESCARTE prospective cohort study in UK general practice</atitle><jtitle>British journal of general practice</jtitle><addtitle>Br J Gen Pract</addtitle><date>2017-09-01</date><risdate>2017</risdate><volume>67</volume><issue>662</issue><spage>e634</spage><epage>e642</epage><pages>e634-e642</pages><issn>0960-1643</issn><eissn>1478-5242</eissn><abstract>A delayed or 'just in case' prescription has been identified as having potential to reduce antibiotic use in sore throat.
To determine the symptomatic outcome of acute sore throat in adults according to antibiotic prescription strategy in routine care.
A secondary analysis of the DESCARTE (Decision rule for the Symptoms and Complications of Acute Red Throat in Everyday practice) prospective cohort study comprising adults aged ≥16 years presenting with acute sore throat (≤2 weeks' duration) managed with treatment as usual in primary care in the UK.
A random sample of 2876 people from the full cohort were requested to complete a symptom diary. A brief clinical proforma was used to collect symptom severity and examination findings at presentation. Outcome details were collected by notes review and a detailed symptom diary. The primary outcome was poorer 'global' symptom control (defined as longer than the median duration or higher than median symptom severity). Analyses controlled for confounding by indication (propensity to prescribe antibiotics).
A total of 1629/2876 (57%) of those requested returned a symptom diary, of whom 1512 had information on prescribing strategy. The proportion with poorer global symptom control was greater in those not prescribed antibiotics 398/587 (68%) compared with those prescribed immediate antibiotics 441/728 (61%) or delayed antibiotic prescription 116/197 59%); adjusted risk ratio (RR) (95% confidence intervals [CI]): immediate RR 0.87 (95% CI = 0.70 to 0.96),
= 0.006; delayed RR 0.88 (95% CI = 0.78 to 1.00),
= 0.042.
In the routine care of adults with sore throat, a delayed antibiotic strategy confers similar symptomatic benefits to immediate antibiotics compared with no antibiotics. If a decision is made to prescribe an antibiotic, a delayed antibiotic strategy is likely to yield similar symptomatic benefit to immediate antibiotics.</abstract><cop>England</cop><pub>Royal College of General Practitioners</pub><pmid>28808075</pmid><doi>10.3399/bjgp17X692321</doi><oa>free_for_read</oa></addata></record> |
| fulltext | fulltext |
| identifier | ISSN: 0960-1643 |
| ispartof | British journal of general practice, 2017-09, Vol.67 (662), p.e634-e642 |
| issn | 0960-1643 1478-5242 |
| language | eng |
| recordid | cdi_pubmedcentral_primary_oai_pubmedcentral_nih_gov_5569743 |
| source | MEDLINE; PubMed Central; Alma/SFX Local Collection |
| subjects | Adult Anti-Bacterial Agents - administration & dosage Cohort Studies Family Practice - methods Family Practice - standards Female Humans Male Middle Aged Patient Reported Outcome Measures Pharyngitis - diagnosis Pharyngitis - drug therapy Pharyngitis - epidemiology Practice Patterns, Physicians' - standards Prospective Studies Quality Improvement Symptom Assessment - methods Symptom Assessment - statistics & numerical data Time-to-Treatment - statistics & numerical data United Kingdom - epidemiology |
| title | Symptom response to antibiotic prescribing strategies in acute sore throat in adults: the DESCARTE prospective cohort study in UK general practice |
| url | https://sfx.bib-bvb.de/sfx_tum?ctx_ver=Z39.88-2004&ctx_enc=info:ofi/enc:UTF-8&ctx_tim=2025-02-11T06%3A31%3A59IST&url_ver=Z39.88-2004&url_ctx_fmt=infofi/fmt:kev:mtx:ctx&rfr_id=info:sid/primo.exlibrisgroup.com:primo3-Article-proquest_pubme&rft_val_fmt=info:ofi/fmt:kev:mtx:journal&rft.genre=article&rft.atitle=Symptom%20response%20to%20antibiotic%20prescribing%20strategies%20in%20acute%20sore%20throat%20in%20adults:%20the%20DESCARTE%20prospective%20cohort%20study%20in%20UK%20general%20practice&rft.jtitle=British%20journal%20of%20general%20practice&rft.au=Moore,%20Michael&rft.aucorp=DESCARTE%20investigators&rft.date=2017-09-01&rft.volume=67&rft.issue=662&rft.spage=e634&rft.epage=e642&rft.pages=e634-e642&rft.issn=0960-1643&rft.eissn=1478-5242&rft_id=info:doi/10.3399/bjgp17X692321&rft_dat=%3Cproquest_pubme%3E1929103824%3C/proquest_pubme%3E%3Curl%3E%3C/url%3E&disable_directlink=true&sfx.directlink=off&sfx.report_link=0&rft_id=info:oai/&rft_pqid=1929103824&rft_id=info:pmid/28808075&rfr_iscdi=true |