Symptom response to antibiotic prescribing strategies in acute sore throat in adults: the DESCARTE prospective cohort study in UK general practice.
<h4>Background</h4> <p>Guidelines recommend prolonged treatment courses for acute sore throat but shorter courses may be used in practice.</p> <h4>Aim</h4> <p>To determine whether antibiotic duration and class predicts adverse outcome of acute sore throat i...
| Main Authors: | , , , , , , , , , , , , , , |
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| Format: | Journal article |
| Language: | English |
| Published: |
Royal College of General Practitioners
2017
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| _version_ | 1797063210932633600 |
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| author | Moore, M Stuart, B Hobbs, F Butler, C Hay, A Campbell, J Delaney, B Broomfield, S Barratt, P Hood, K Everitt, H Mullee, M Williamson, I Mant, D Little, P |
| author_facet | Moore, M Stuart, B Hobbs, F Butler, C Hay, A Campbell, J Delaney, B Broomfield, S Barratt, P Hood, K Everitt, H Mullee, M Williamson, I Mant, D Little, P |
| author_sort | Moore, M |
| collection | OXFORD |
| description | <h4>Background</h4> <p>Guidelines recommend prolonged treatment courses for acute sore throat but shorter courses may be used in practice.</p> <h4>Aim</h4> <p>To determine whether antibiotic duration and class predicts adverse outcome of acute sore throat in adults in routine care.</p> <h4>Design and setting</h4> <p>A secondary analysis of a prospective cohort study of 14610 adults presenting with acute sore throat in primary care.</p> <h4>Methods</h4> <p>A brief clinical proforma was used to collect symptom severity and examination findings at presentation. Outcomes were collected by notes review and in a sample a symptom diary. Primary outcome: Re-consultation with new/non-resolving symptoms within 1 month. Secondary outcome ‘global’ poorer symptom control (longer than the median duration or higher than median severity). </p> <h4>Results</h4> <p>Antibiotics were prescribed for 60% (8572/14610) of participants. The most commonly prescribed antibiotic was phenoxymethylpenicillin (76%, 5656/7474) and prescription durations were 5 (20%), 7 (57%), or 10 (22%) days.. Compared with 5 day courses those receiving longer courses were less likely to re-consult with new or worsening symptoms 5 days 15.3%, 7 days 13.9%, 10 days 12.2%, (7 day course adjusted risk ratio 0·92 (0·76, 1·11) and 10 days 0·86 (0·59, 1·23)) but this difference did not reach statistical significance.</p> <h4>Conclusions</h4> <p>In adults prescribed antibiotics for sore throat, we cannot rule out a small advantage in terms of reduced re-consultation for a 10 day course of penicillin but that effect is likely to be small.</p> |
| first_indexed | 2024-03-06T20:56:34Z |
| format | Journal article |
| id | oxford-uuid:3976a12f-b678-4d67-8e03-91db411a7026 |
| institution | University of Oxford |
| language | English |
| last_indexed | 2024-03-06T20:56:34Z |
| publishDate | 2017 |
| publisher | Royal College of General Practitioners |
| record_format | dspace |
| spelling | oxford-uuid:3976a12f-b678-4d67-8e03-91db411a70262022-03-26T13:55:44ZSymptom response to antibiotic prescribing strategies in acute sore throat in adults: the DESCARTE prospective cohort study in UK general practice.Journal articlehttp://purl.org/coar/resource_type/c_dcae04bcuuid:3976a12f-b678-4d67-8e03-91db411a7026EnglishSymplectic Elements at OxfordRoyal College of General Practitioners2017Moore, MStuart, BHobbs, FButler, CHay, ACampbell, JDelaney, BBroomfield, SBarratt, PHood, KEveritt, HMullee, MWilliamson, IMant, DLittle, P <h4>Background</h4> <p>Guidelines recommend prolonged treatment courses for acute sore throat but shorter courses may be used in practice.</p> <h4>Aim</h4> <p>To determine whether antibiotic duration and class predicts adverse outcome of acute sore throat in adults in routine care.</p> <h4>Design and setting</h4> <p>A secondary analysis of a prospective cohort study of 14610 adults presenting with acute sore throat in primary care.</p> <h4>Methods</h4> <p>A brief clinical proforma was used to collect symptom severity and examination findings at presentation. Outcomes were collected by notes review and in a sample a symptom diary. Primary outcome: Re-consultation with new/non-resolving symptoms within 1 month. Secondary outcome ‘global’ poorer symptom control (longer than the median duration or higher than median severity). </p> <h4>Results</h4> <p>Antibiotics were prescribed for 60% (8572/14610) of participants. The most commonly prescribed antibiotic was phenoxymethylpenicillin (76%, 5656/7474) and prescription durations were 5 (20%), 7 (57%), or 10 (22%) days.. Compared with 5 day courses those receiving longer courses were less likely to re-consult with new or worsening symptoms 5 days 15.3%, 7 days 13.9%, 10 days 12.2%, (7 day course adjusted risk ratio 0·92 (0·76, 1·11) and 10 days 0·86 (0·59, 1·23)) but this difference did not reach statistical significance.</p> <h4>Conclusions</h4> <p>In adults prescribed antibiotics for sore throat, we cannot rule out a small advantage in terms of reduced re-consultation for a 10 day course of penicillin but that effect is likely to be small.</p> |
| spellingShingle | Moore, M Stuart, B Hobbs, F Butler, C Hay, A Campbell, J Delaney, B Broomfield, S Barratt, P Hood, K Everitt, H Mullee, M Williamson, I Mant, D Little, P Symptom response to antibiotic prescribing strategies in acute sore throat in adults: the DESCARTE prospective cohort study in UK general practice. |
| title | Symptom response to antibiotic prescribing strategies in acute sore throat in adults: the DESCARTE prospective cohort study in UK general practice. |
| title_full | Symptom response to antibiotic prescribing strategies in acute sore throat in adults: the DESCARTE prospective cohort study in UK general practice. |
| title_fullStr | Symptom response to antibiotic prescribing strategies in acute sore throat in adults: the DESCARTE prospective cohort study in UK general practice. |
| title_full_unstemmed | Symptom response to antibiotic prescribing strategies in acute sore throat in adults: the DESCARTE prospective cohort study in UK general practice. |
| title_short | Symptom response to antibiotic prescribing strategies in acute sore throat in adults: the DESCARTE prospective cohort study in UK general practice. |
| title_sort | symptom response to antibiotic prescribing strategies in acute sore throat in adults the descarte prospective cohort study in uk general practice |
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