Influence of the duration of penicillin prescriptions on outcomes for 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...

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Autori principali: 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
Natura: Journal article
Lingua:English
Pubblicazione: Royal College of General Practitioners 2017
_version_ 1826293528178720768
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>
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spelling oxford-uuid:bae4db2f-0a9b-44d4-93f6-d973dda786ee2022-03-27T05:12:58ZInfluence of the duration of penicillin prescriptions on outcomes for acute sore throat in adults: the DESCARTE prospective cohort study in UK general practice.Journal articlehttp://purl.org/coar/resource_type/c_dcae04bcuuid:bae4db2f-0a9b-44d4-93f6-d973dda786eeEnglishSymplectic 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
Influence of the duration of penicillin prescriptions on outcomes for acute sore throat in adults: the DESCARTE prospective cohort study in UK general practice.
title Influence of the duration of penicillin prescriptions on outcomes for acute sore throat in adults: the DESCARTE prospective cohort study in UK general practice.
title_full Influence of the duration of penicillin prescriptions on outcomes for acute sore throat in adults: the DESCARTE prospective cohort study in UK general practice.
title_fullStr Influence of the duration of penicillin prescriptions on outcomes for acute sore throat in adults: the DESCARTE prospective cohort study in UK general practice.
title_full_unstemmed Influence of the duration of penicillin prescriptions on outcomes for acute sore throat in adults: the DESCARTE prospective cohort study in UK general practice.
title_short Influence of the duration of penicillin prescriptions on outcomes for acute sore throat in adults: the DESCARTE prospective cohort study in UK general practice.
title_sort influence of the duration of penicillin prescriptions on outcomes for acute sore throat in adults the descarte prospective cohort study in uk general practice
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