Re-examining advice to complete antibiotic courses: a qualitative study with clinicians and patients
Background: Antibiotic treatment duration may be longer than sometimes needed. Stopping antibiotics early, rather than completing pre-set antibiotic courses, may help reduce unnecessary exposure to antibiotics and antimicrobial resistance (AMR). Aim: To identify clinicians' and patients' v...
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| Format: | Article |
| Language: | English |
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Royal College of General Practitioners
2023-06-01
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| Series: | BJGP Open |
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| Online Access: | https://bjgpopen.org/content/7/2/BJGPO.2022.0170 |
| _version_ | 1797787768146886656 |
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| author | Aleksandra J Borek George Edwards Marta Santillo Marta Wanat Margaret Glogowska Christopher C Butler Ann Sarah Walker Gail Hayward Sarah Tonkin-Crine |
| author_facet | Aleksandra J Borek George Edwards Marta Santillo Marta Wanat Margaret Glogowska Christopher C Butler Ann Sarah Walker Gail Hayward Sarah Tonkin-Crine |
| author_sort | Aleksandra J Borek |
| collection | DOAJ |
| description | Background: Antibiotic treatment duration may be longer than sometimes needed. Stopping antibiotics early, rather than completing pre-set antibiotic courses, may help reduce unnecessary exposure to antibiotics and antimicrobial resistance (AMR). Aim: To identify clinicians' and patients' views on stopping antibiotics when better (SAWB) for urinary tract infections (UTIs), and to explore comparisons with other acute infections. Design & setting: An exploratory qualitative study with general practice clinicians and patients in England. Method: Primary care clinicians and patients who had recent UTI experience were recruited in England. Remote one-to-one interviews with clinicians and patients, and one focus group with patients, were conducted. Data were audiorecorded, transcribed, and analysed thematically. Results: Eleven clinicians (seven GPs) and 19 patients (14 with experience of recurrent and/or chronic UTIs) were included. All participants considered SAWB unfamiliar and contradictory to well-known advice to complete antibiotic courses, but were interested in the evidence for risks and benefits of SAWB. Clinicians were amenable if evidence and guidelines supported it, whereas patients were more averse because of concerns about the risk of UTI recurrence and/or complications and AMR. Participants viewed SAWB as potentially more appropriate for longer antibiotic courses and other infections (with longer courses and lower risk of recurrence and/or complications). Participants stressed the need for unambiguous advice and SAWB as part of shared decision making and personalised advice. Conclusion: Patients were less accepting of SAWB, whereas clinicians were more amenable to it. Patients and clinicians require good evidence that this novel approach to self-determining antibiotic duration is safe and beneficial. If evidence based, SAWB should be offered with an explanation of why the advice differs from the ‘complete the course’ instruction, and a clear indication of when exactly to stop antibiotics should be given. |
| first_indexed | 2024-03-13T01:26:33Z |
| format | Article |
| id | doaj.art-bc6a933b6cb4473db5084b7856881834 |
| institution | Directory Open Access Journal |
| issn | 2398-3795 |
| language | English |
| last_indexed | 2024-03-13T01:26:33Z |
| publishDate | 2023-06-01 |
| publisher | Royal College of General Practitioners |
| record_format | Article |
| series | BJGP Open |
| spelling | doaj.art-bc6a933b6cb4473db5084b78568818342023-07-04T14:41:43ZengRoyal College of General PractitionersBJGP Open2398-37952023-06-017210.3399/BJGPO.2022.0170Re-examining advice to complete antibiotic courses: a qualitative study with clinicians and patientsAleksandra J Borek0George Edwards1Marta Santillo2Marta Wanat3Margaret Glogowska4Christopher C Butler5Ann Sarah Walker6Gail Hayward7Sarah Tonkin-Crine8Nuffield Department of Primary Care Health Sciences, University of Oxford, Oxford, UKNuffield Department of Primary Care Health Sciences, University of Oxford, Oxford, UKNuffield Department of Primary Care Health Sciences, University of Oxford, Oxford, UKNuffield Department of Primary Care Health Sciences, University of Oxford, Oxford, UKNuffield Department of Primary Care Health Sciences, University of Oxford, Oxford, UKNuffield Department of Primary Care Health Sciences, University of Oxford, Oxford, UKNational Institute for Health and Care Research (NIHR) Health Protection Research Unit in Healthcare Associated Infections and Antimicrobial Resistance, University of Oxford, Oxford, UKNuffield Department of Primary Care Health Sciences, University of Oxford, Oxford, UKNuffield Department of Primary Care Health Sciences, University of Oxford, Oxford, UKBackground: Antibiotic treatment duration may be longer than sometimes needed. Stopping antibiotics early, rather than completing pre-set antibiotic courses, may help reduce unnecessary exposure to antibiotics and antimicrobial resistance (AMR). Aim: To identify clinicians' and patients' views on stopping antibiotics when better (SAWB) for urinary tract infections (UTIs), and to explore comparisons with other acute infections. Design & setting: An exploratory qualitative study with general practice clinicians and patients in England. Method: Primary care clinicians and patients who had recent UTI experience were recruited in England. Remote one-to-one interviews with clinicians and patients, and one focus group with patients, were conducted. Data were audiorecorded, transcribed, and analysed thematically. Results: Eleven clinicians (seven GPs) and 19 patients (14 with experience of recurrent and/or chronic UTIs) were included. All participants considered SAWB unfamiliar and contradictory to well-known advice to complete antibiotic courses, but were interested in the evidence for risks and benefits of SAWB. Clinicians were amenable if evidence and guidelines supported it, whereas patients were more averse because of concerns about the risk of UTI recurrence and/or complications and AMR. Participants viewed SAWB as potentially more appropriate for longer antibiotic courses and other infections (with longer courses and lower risk of recurrence and/or complications). Participants stressed the need for unambiguous advice and SAWB as part of shared decision making and personalised advice. Conclusion: Patients were less accepting of SAWB, whereas clinicians were more amenable to it. Patients and clinicians require good evidence that this novel approach to self-determining antibiotic duration is safe and beneficial. If evidence based, SAWB should be offered with an explanation of why the advice differs from the ‘complete the course’ instruction, and a clear indication of when exactly to stop antibiotics should be given.https://bjgpopen.org/content/7/2/BJGPO.2022.0170antibiotic coursedrug resistance, microbialantimicrobial stewardshipcommunicable diseasesprimary health carequalitative research |
| spellingShingle | Aleksandra J Borek George Edwards Marta Santillo Marta Wanat Margaret Glogowska Christopher C Butler Ann Sarah Walker Gail Hayward Sarah Tonkin-Crine Re-examining advice to complete antibiotic courses: a qualitative study with clinicians and patients BJGP Open antibiotic course drug resistance, microbial antimicrobial stewardship communicable diseases primary health care qualitative research |
| title | Re-examining advice to complete antibiotic courses: a qualitative study with clinicians and patients |
| title_full | Re-examining advice to complete antibiotic courses: a qualitative study with clinicians and patients |
| title_fullStr | Re-examining advice to complete antibiotic courses: a qualitative study with clinicians and patients |
| title_full_unstemmed | Re-examining advice to complete antibiotic courses: a qualitative study with clinicians and patients |
| title_short | Re-examining advice to complete antibiotic courses: a qualitative study with clinicians and patients |
| title_sort | re examining advice to complete antibiotic courses a qualitative study with clinicians and patients |
| topic | antibiotic course drug resistance, microbial antimicrobial stewardship communicable diseases primary health care qualitative research |
| url | https://bjgpopen.org/content/7/2/BJGPO.2022.0170 |
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