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首页> 外文期刊>BMC Family Practice >Use of delayed antibiotic prescription in primary care: a cross-sectional study
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Use of delayed antibiotic prescription in primary care: a cross-sectional study

机译：在初级保健中使用延迟抗生素处方的横断面研究

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One of several strategies developed to reduce inappropriate antibiotic use in situations where the indication is not clear is delayed antibiotic prescription (DAP), defined as an antibiotic prescription issued for the patient to take only in case of feeling worse or not feeling better several days after the visit. We conducted a survey to identify DAP use in Spanish primary care settings. We surveyed 23 healthcare centers located in 4 autonomous regions where a randomized controlled trial (RCT) on DAP was underway. The primary variable was use of DAP. Categorical and quantitative variables were analyzed by means of the chi-squared test and non-parametric tests, respectively. The survey was sent to 375 healthcare professionals, 215 of whom responded (57.3% response rate), with 46% of these respondents declaring that they had used DAP in routine practice before the RCT started (66.6% afterwards), mostly (91.5%) for respiratory tract infections (RTIs), followed by urinary infections (45.1%). Regarding DAP use for RTIs, the most frequent conditions were pharyngotonsillitis (88.7%), acute bronchitis (62.7%), mild chronic obstructive pulmonary disease exacerbations (59.9%), sinusitis (51.4%), and acute otitis media (45.1%). Most respondents considered that DAP reduced emergency visits (85.4%), scheduled visits (79%) and inappropriate antibiotic use (73.7%) and most also perceived patients to be generally satisfied with the DAP approach (75.6%). Having participated or not in the DAP RCT (74.1% versus 46.2%; p??0.001), having previously used or not used DAP (86.8% versus 44.2%; p??0.001), and being a physician versus being a nurse (81.8% versus 18.2%; p??0.001) were factors that reflected significantly higher rates of DAP use. The majority of primary healthcare professionals in Spain do not use DAP. Those who use DAP believe that it reduces primary care visits and inappropriate antibiotic use, while maintaining patient satisfaction. Given the limited use of DAP in our setting, and given that its use is mainly limited to RTIs, DAP has considerable potential in terms of its implementation in routine practice.
机译：为减少在适应症不明确的情况下不适当使用抗生素而开发的几种策略之一是延迟抗生素处方（DAP），这是一种抗生素处方，仅在患者感到不适或几天后感觉不佳时才签发给患者访问。我们进行了一项调查，以确定西班牙基层医疗机构中使用DAP的情况。我们调查了位于4个自治区的23个医疗中心，这些中心正在进行DAP的随机对照试验（RCT）。主要变量是使用DAP。分类变量和定量变量分别通过卡方检验和非参数检验进行分析。该调查共发送给375名医疗保健专业人士，其中215人做出了回应（57.3％的回应率），其中46％的受访者宣称他们在RCT开始之前已在常规实践中使用DAP（此后为66.6％），大部分是（91.5％）呼吸道感染（RTIs），然后是尿路感染（45.1％）。关于DAP用于RTI的情况，最常见的情况是咽喉炎（88.7％），急性支气管炎（62.7％），轻度慢性阻塞性肺疾病恶化（59.9％），鼻窦炎（51.4％）和急性中耳炎（45.1％）。大多数受访者认为DAP减少了急诊就诊（85.4％），定期就诊（79％）和不适当的抗生素使用（73.7％），并且大多数人还认为患者对DAP的治疗方法总体上感到满意（75.6％）。是否参加过DAP RCT（74.1％vs 46.2％; p <0.001），以前曾使用过或未使用过DAP（86.8％vs 44.2％; p 0.001），并且是医师而非护士（81.8％对18.2％; p <0.001）是反映DAP使用率显着提高的因素。西班牙的大多数主要医疗保健专业人员都不使用DAP。那些使用DAP的人认为，它可以减少初级保健就诊次数和不当使用抗生素，同时保持患者满意度。鉴于在我们的环境中DAP的使用受到限制，并且由于DAP的使用主要限于RTI，因此DAP在常规实践中具有很大的潜力。

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