Predictors for antibiotic prescribing in patients with exacerbations of COPD in general practice

Carl Llor, Lars Bjerrum, Anders Munck, Gloria Cristina Córdoba, Eva Lena Stranderg, Ingvar Ovhed, Ruta Radzeviciene, Josep M Cots, Anatoliy Reutskiy, Lidia Caballero, Malene Plejdrup Hansen

Publikation: Bidrag til tidsskriftTidsskriftartikelForskningpeer review

Resumé

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.
OriginalsprogEngelsk
TidsskriftTherapeutic Advances in Respiratory Disease
Vol/bind7
Udgave nummer3
Sider (fra-til)131-137
ISSN1753-4658
DOI
StatusUdgivet - 2013

Fingeraftryk

General Practice
Chronic Obstructive Pulmonary Disease
General Practitioners
Denmark
Logistic Models
Odds Ratio
Confidence Intervals
Lithuania
Cough
Primary Health Care
Cross-Sectional Studies
Physicians

Citer dette

Llor, Carl ; Bjerrum, Lars ; Munck, Anders ; Córdoba, Gloria Cristina ; Stranderg, Eva Lena ; Ovhed, Ingvar ; Radzeviciene, Ruta ; Cots, Josep M ; Reutskiy, Anatoliy ; Caballero, Lidia ; Plejdrup Hansen, Malene. / Predictors for antibiotic prescribing in patients with exacerbations of COPD in general practice. I: Therapeutic Advances in Respiratory Disease. 2013 ; Bind 7, Nr. 3. s. 131-137.
@article{2c9a9b0488784d95bad916d674898e24,
title = "Predictors for antibiotic prescribing in patients with exacerbations of COPD in general practice",
abstract = "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.",
author = "Carl Llor and Lars Bjerrum and Anders Munck and C{\'o}rdoba, {Gloria Cristina} and Stranderg, {Eva Lena} and Ingvar Ovhed and Ruta Radzeviciene and Cots, {Josep M} and Anatoliy Reutskiy and Lidia Caballero and {Plejdrup Hansen}, Malene",
year = "2013",
doi = "10.1177/1753465812472387",
language = "English",
volume = "7",
pages = "131--137",
journal = "Therapeutic Advances in Respiratory Disease",
issn = "1753-4658",
publisher = "SAGE Publications",
number = "3",

}

Llor, C, Bjerrum, L, Munck, A, Córdoba, GC, Stranderg, EL, Ovhed, I, Radzeviciene, R, Cots, JM, Reutskiy, A, Caballero, L & Plejdrup Hansen, M 2013, 'Predictors for antibiotic prescribing in patients with exacerbations of COPD in general practice', Therapeutic Advances in Respiratory Disease, bind 7, nr. 3, s. 131-137. https://doi.org/10.1177/1753465812472387

Predictors for antibiotic prescribing in patients with exacerbations of COPD in general practice. / Llor, Carl; Bjerrum, Lars; Munck, Anders; Córdoba, Gloria Cristina; Stranderg, Eva Lena; Ovhed, Ingvar; Radzeviciene, Ruta; Cots, Josep M; Reutskiy, Anatoliy; Caballero, Lidia; Plejdrup Hansen, Malene.

I: Therapeutic Advances in Respiratory Disease, Bind 7, Nr. 3, 2013, s. 131-137.

Publikation: Bidrag til tidsskriftTidsskriftartikelForskningpeer review

TY - JOUR

T1 - Predictors for antibiotic prescribing in patients with exacerbations of COPD in general practice

AU - Llor, Carl

AU - Bjerrum, Lars

AU - Munck, Anders

AU - Córdoba, Gloria Cristina

AU - Stranderg, Eva Lena

AU - Ovhed, Ingvar

AU - Radzeviciene, Ruta

AU - Cots, Josep M

AU - Reutskiy, Anatoliy

AU - Caballero, Lidia

AU - Plejdrup Hansen, Malene

PY - 2013

Y1 - 2013

N2 - 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.

AB - 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.

U2 - 10.1177/1753465812472387

DO - 10.1177/1753465812472387

M3 - Journal article

C2 - 23325784

VL - 7

SP - 131

EP - 137

JO - Therapeutic Advances in Respiratory Disease

JF - Therapeutic Advances in Respiratory Disease

SN - 1753-4658

IS - 3

ER -