Document Detail


Predictors for antibiotic prescribing in patients with exacerbations of COPD in general practice.
MedLine Citation:
PMID:  23325784     Owner:  NLM     Status:  Publisher    
Abstract/OtherAbstract:
BACKGROUND: The aim of this study was to describe the antibiotic prescribing rate in patients with acute exacerbation of chronic obstructive pulmonary disease (AECOPD), to analyse predictors for antibiotic prescribing and to explore the influence of the use C-reactive protein (CRP) rapid test. METHODS: A cross-sectional study was carried out in January and February 2008 in primary care. General practitioners (GPs) from six countries (Denmark, Sweden, Lithuania, Russia, Spain and Argentina) registered all patients with AECOPD during a 3-week period. A multilevel logistic regression model was estimated using two hierarchical levels, (i) patients and (ii) physicians, and was used to analyse the association between antibiotic prescribing and potential predictors for antibiotic use: patients' age and gender, duration and symptoms and signs of exacerbations (fever, cough, dyspnoea, sputum volume and purulence) and the results of the CRP test. RESULTS: A total of 617 GPs registered 1233 patients with AECOPD. A total of 970 patients (79%) were prescribed antibiotics, varying from 49% (Denmark) to 93% (Russia). The presence of purulent sputum was the strongest predictor for antibiotic treatment (odds ratio [OR] 8.7; 95% confidence interval [CI] 5.9-12.8). CRP determination was carried out mainly in Denmark and Sweden and its use was the strongest protective factor for antibiotic therapy (OR 0.3; 95% CI 0.2-0.6). GPs that used CRP testing weighted purulent sputum lower than GPs who did not use CRP testing. CRP values had a strong influence on the antibiotic prescribing rate. CONCLUSIONS: Antibiotic treatment for AECOPD is very high. This study shows that GPs performing CRP rapid tests prescribe fewer antibiotics than those who do not.
Authors:
Carl Llor; Lars Bjerrum; Anders Munck; Malene P Hansen; Gloria Cristina Córdoba; Eva Lena Stranderg; Ingvar Ovhed; Ruta Radzeviciene; Josep M Cots; Anatoliy Reutskiy; Lidia Caballero
Related Documents :
24164924 - Impact of vancomycin resistance on mortality in neutropenic patients with enterococcal ...
24394734 - Guideline adherence for empirical treatment of pneumonia and patient outcome. treating ...
24071544 - Health-care associated bacteremia in geriatric cancer patients with febrile neutropenia.
23151724 - Comparative evaluation of warfarin utilisation in two primary healthcare clinics in the...
21510234 - Comorbidities in cluster headache and migraine.
16608944 - Long-term mortality outcome associated with prolonged admission to the icu.
Publication Detail:
Type:  JOURNAL ARTICLE     Date:  2013-1-16
Journal Detail:
Title:  Therapeutic advances in respiratory disease     Volume:  -     ISSN:  1753-4666     ISO Abbreviation:  Ther Adv Respir Dis     Publication Date:  2013 Jan 
Date Detail:
Created Date:  2013-1-17     Completed Date:  -     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  101316317     Medline TA:  Ther Adv Respir Dis     Country:  -    
Other Details:
Languages:  ENG     Pagination:  -     Citation Subset:  -    
Affiliation:
University Rovira i Virgili, Primary Healthcare Centre Jaume I, Tarragona, Spain.
Export Citation:
APA/MLA Format     Download EndNote     Download BibTex
MeSH Terms
Descriptor/Qualifier:

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


Previous Document:  Renal cell carcinoma metastases to the pancreas: value of arterial phase imaging at MDCT.
Next Document:  Rab1b overexpression modifies Golgi size and gene expression in HeLa cells and modulates the thyrotr...