An intervention with access to C-reactive protein rapid test reduces antibiotic overprescribing in acute exacerbations of chronic bronchitis and COPD

Research output: Contribution to journalJournal articleResearchpeer-review

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An intervention with access to C-reactive protein rapid test reduces antibiotic overprescribing in acute exacerbations of chronic bronchitis and COPD. / F. Strykowski, David; Nielsen, Anni Brit Sternhagen; Llor, Carles; Siersma, Volkert Dirk; Bjerrum, Lars.

In: Family Practice, Vol. 32, No. 4, 2015, p. 395-400.

Research output: Contribution to journalJournal articleResearchpeer-review

Harvard

F. Strykowski, D, Nielsen, ABS, Llor, C, Siersma, VD & Bjerrum, L 2015, 'An intervention with access to C-reactive protein rapid test reduces antibiotic overprescribing in acute exacerbations of chronic bronchitis and COPD', Family Practice, vol. 32, no. 4, pp. 395-400. https://doi.org/10.1093/fampra/cmv020

APA

F. Strykowski, D., Nielsen, A. B. S., Llor, C., Siersma, V. D., & Bjerrum, L. (2015). An intervention with access to C-reactive protein rapid test reduces antibiotic overprescribing in acute exacerbations of chronic bronchitis and COPD. Family Practice, 32(4), 395-400. https://doi.org/10.1093/fampra/cmv020

Vancouver

F. Strykowski D, Nielsen ABS, Llor C, Siersma VD, Bjerrum L. An intervention with access to C-reactive protein rapid test reduces antibiotic overprescribing in acute exacerbations of chronic bronchitis and COPD. Family Practice. 2015;32(4):395-400. https://doi.org/10.1093/fampra/cmv020

Author

F. Strykowski, David ; Nielsen, Anni Brit Sternhagen ; Llor, Carles ; Siersma, Volkert Dirk ; Bjerrum, Lars. / An intervention with access to C-reactive protein rapid test reduces antibiotic overprescribing in acute exacerbations of chronic bronchitis and COPD. In: Family Practice. 2015 ; Vol. 32, No. 4. pp. 395-400.

Bibtex

@article{bbffde147e5d4608a8305101f6625800,
title = "An intervention with access to C-reactive protein rapid test reduces antibiotic overprescribing in acute exacerbations of chronic bronchitis and COPD",
abstract = "Background. In acute exacerbation of chronic obstructive pulmonary disease (AECOPD) antibiotic overprescribing leads to antimicrobial resistance and underprescribing may cause poor patient outcomes. Objective. This study aimed to evaluate changes in over- and underprescribing of antibiotics after two interventions to optimize antibiotic prescribing in AECOPD in Spain. Methods. In 2008 and 2009, general practitioners (GPs) registered patients in a 3-week period before and after interventions. Two types of intervention were conducted: GPs in the full-intervention group (FIG) were exposed to a multifaceted intervention and given access to C-reactive protein (CRP) rapid test; partial-intervention group (PIG) was only exposed to the multifaceted intervention. Overprescribing was defined as antibiotic given to type III* exacerbation (≤ one Anthonisen Criteria); underprescribing was defined as no antibiotic given to type I exacerbation (three Anthonisen Criteria). A multivariate logistic regression model was used, considering antibiotic prescribing as the dependent variable. Results. A total of 210 GPs and 70 GPs were assigned to FIG and PIG, respectively, and 952 AECOPD patients were eligible for main analysis. After adjusting for clustering at GP level and for patient age and sex, we found that GPs in FIG significantly reduced antibiotic overprescribing; odds ratio (OR) = 0.35 (95{\%} CI: 0.18–0.68, P = 0.003) and underprescribing was not significantly increased; OR = 0.25 (95{\%} CI: 0.06 to 1.0, P = 0.075). No statistically significant changes were found in the PIG. Conclusion. Antibiotic overprescribing was only reduced when CRP test was available. Simultaneously, underprescribing was not significantly increased, but this could be due to sample size limitations.",
keywords = "Faculty of Health and Medical Sciences, Antibacterial agents, C-reactive protein, chronic obstructive pulmonary disease, Drug therapy, Drug Prescriptions, General practice, respiratory tract infections, therapeutic use",
author = "{F. Strykowski}, David and Nielsen, {Anni Brit Sternhagen} and Carles Llor and Siersma, {Volkert Dirk} and Lars Bjerrum",
year = "2015",
doi = "10.1093/fampra/cmv020",
language = "English",
volume = "32",
pages = "395--400",
journal = "Family Practice",
issn = "0263-2136",
publisher = "Oxford University Press",
number = "4",

}

RIS

TY - JOUR

T1 - An intervention with access to C-reactive protein rapid test reduces antibiotic overprescribing in acute exacerbations of chronic bronchitis and COPD

AU - F. Strykowski, David

AU - Nielsen, Anni Brit Sternhagen

AU - Llor, Carles

AU - Siersma, Volkert Dirk

AU - Bjerrum, Lars

PY - 2015

Y1 - 2015

N2 - Background. In acute exacerbation of chronic obstructive pulmonary disease (AECOPD) antibiotic overprescribing leads to antimicrobial resistance and underprescribing may cause poor patient outcomes. Objective. This study aimed to evaluate changes in over- and underprescribing of antibiotics after two interventions to optimize antibiotic prescribing in AECOPD in Spain. Methods. In 2008 and 2009, general practitioners (GPs) registered patients in a 3-week period before and after interventions. Two types of intervention were conducted: GPs in the full-intervention group (FIG) were exposed to a multifaceted intervention and given access to C-reactive protein (CRP) rapid test; partial-intervention group (PIG) was only exposed to the multifaceted intervention. Overprescribing was defined as antibiotic given to type III* exacerbation (≤ one Anthonisen Criteria); underprescribing was defined as no antibiotic given to type I exacerbation (three Anthonisen Criteria). A multivariate logistic regression model was used, considering antibiotic prescribing as the dependent variable. Results. A total of 210 GPs and 70 GPs were assigned to FIG and PIG, respectively, and 952 AECOPD patients were eligible for main analysis. After adjusting for clustering at GP level and for patient age and sex, we found that GPs in FIG significantly reduced antibiotic overprescribing; odds ratio (OR) = 0.35 (95% CI: 0.18–0.68, P = 0.003) and underprescribing was not significantly increased; OR = 0.25 (95% CI: 0.06 to 1.0, P = 0.075). No statistically significant changes were found in the PIG. Conclusion. Antibiotic overprescribing was only reduced when CRP test was available. Simultaneously, underprescribing was not significantly increased, but this could be due to sample size limitations.

AB - Background. In acute exacerbation of chronic obstructive pulmonary disease (AECOPD) antibiotic overprescribing leads to antimicrobial resistance and underprescribing may cause poor patient outcomes. Objective. This study aimed to evaluate changes in over- and underprescribing of antibiotics after two interventions to optimize antibiotic prescribing in AECOPD in Spain. Methods. In 2008 and 2009, general practitioners (GPs) registered patients in a 3-week period before and after interventions. Two types of intervention were conducted: GPs in the full-intervention group (FIG) were exposed to a multifaceted intervention and given access to C-reactive protein (CRP) rapid test; partial-intervention group (PIG) was only exposed to the multifaceted intervention. Overprescribing was defined as antibiotic given to type III* exacerbation (≤ one Anthonisen Criteria); underprescribing was defined as no antibiotic given to type I exacerbation (three Anthonisen Criteria). A multivariate logistic regression model was used, considering antibiotic prescribing as the dependent variable. Results. A total of 210 GPs and 70 GPs were assigned to FIG and PIG, respectively, and 952 AECOPD patients were eligible for main analysis. After adjusting for clustering at GP level and for patient age and sex, we found that GPs in FIG significantly reduced antibiotic overprescribing; odds ratio (OR) = 0.35 (95% CI: 0.18–0.68, P = 0.003) and underprescribing was not significantly increased; OR = 0.25 (95% CI: 0.06 to 1.0, P = 0.075). No statistically significant changes were found in the PIG. Conclusion. Antibiotic overprescribing was only reduced when CRP test was available. Simultaneously, underprescribing was not significantly increased, but this could be due to sample size limitations.

KW - Faculty of Health and Medical Sciences

KW - Antibacterial agents

KW - C-reactive protein

KW - chronic obstructive pulmonary disease

KW - Drug therapy

KW - Drug Prescriptions

KW - General practice

KW - respiratory tract infections

KW - therapeutic use

U2 - 10.1093/fampra/cmv020

DO - 10.1093/fampra/cmv020

M3 - Journal article

VL - 32

SP - 395

EP - 400

JO - Family Practice

JF - Family Practice

SN - 0263-2136

IS - 4

ER -

ID: 132467749