Temporal patterns of antibiotic prescribing for sore throat, otitis media, and sinusitis: a longitudinal study of general practitioner registrars.

anti-bacterial agents antimicrobial stewardship general practitioners graduate medical education inappropriate prescribing respiratory tract infections

Journal

Family practice
ISSN: 1460-2229
Titre abrégé: Fam Pract
Pays: England
ID NLM: 8500875

Informations de publication

Date de publication:
24 May 2023
Historique:
medline: 25 5 2023
pubmed: 25 5 2023
entrez: 24 5 2023
Statut: aheadofprint

Résumé

Antibiotics provide minimal benefit for sore throat, otitis media, and sinusitis. Antibiotic stewardship, with reduced prescribing, is required to address antibiotic resistance. As most antibiotic prescribing occurs in general practice and prescribing habits develop early, general practitioner (GP) trainees (registrars) are important for effective antibiotic stewardship. To establish temporal trends in Australian registrars' antibiotic prescribing for acute sore throat, acute otitis media, and acute sinusitis. A longitudinal analysis of data from the Registrar Clinical Encounters in Training (ReCEnT) study from 2010 to 2019. ReCEnT is an ongoing cohort study of registrars' in-consultation experiences and clinical behaviours. Pre-2016, 5 of 17 Australian training regions participated. From 2016, 3 of 9 regions (42% of Australian registrars) participate. The outcome was prescription of an antibiotic for a new acute problem/diagnosis of sore throat, otitis media, or sinusitis. The study factor was year (2010-2019). Antibiotics were prescribed in 66% of sore throat diagnoses, 81% of otitis media, and in 72% of sinusitis. Prescribing frequencies decreased between 2010 and 2019 by 16% for sore throat (from 76% to 60%) by 11% for otitis media (from 88% to 77%) and by 18% for sinusitis (from 84% to 66%). In multivariable analyses, "Year" was associated with reduced prescribing for sore throat (OR 0.89; 95%CI 0.86-0.92; p < 0.001), otitis media (OR 0.90; 95%CI 0.86-0.94; p < 0.001), and sinusitis (OR 0.90; 95%CI 0.86, 0.94; p < 0.001). Registrars' prescribing rates for sore throat, otitis media, and sinusitis significantly decreased during the period 2010-2019. However, educational (and other) interventions to further reduce prescribing are warranted.

Sections du résumé

BACKGROUND BACKGROUND
Antibiotics provide minimal benefit for sore throat, otitis media, and sinusitis. Antibiotic stewardship, with reduced prescribing, is required to address antibiotic resistance. As most antibiotic prescribing occurs in general practice and prescribing habits develop early, general practitioner (GP) trainees (registrars) are important for effective antibiotic stewardship.
OBJECTIVES OBJECTIVE
To establish temporal trends in Australian registrars' antibiotic prescribing for acute sore throat, acute otitis media, and acute sinusitis.
DESIGN METHODS
A longitudinal analysis of data from the Registrar Clinical Encounters in Training (ReCEnT) study from 2010 to 2019.
PARTICIPANTS METHODS
ReCEnT is an ongoing cohort study of registrars' in-consultation experiences and clinical behaviours. Pre-2016, 5 of 17 Australian training regions participated. From 2016, 3 of 9 regions (42% of Australian registrars) participate.
MAIN MEASURES METHODS
The outcome was prescription of an antibiotic for a new acute problem/diagnosis of sore throat, otitis media, or sinusitis. The study factor was year (2010-2019).
KEY RESULTS RESULTS
Antibiotics were prescribed in 66% of sore throat diagnoses, 81% of otitis media, and in 72% of sinusitis. Prescribing frequencies decreased between 2010 and 2019 by 16% for sore throat (from 76% to 60%) by 11% for otitis media (from 88% to 77%) and by 18% for sinusitis (from 84% to 66%). In multivariable analyses, "Year" was associated with reduced prescribing for sore throat (OR 0.89; 95%CI 0.86-0.92; p < 0.001), otitis media (OR 0.90; 95%CI 0.86-0.94; p < 0.001), and sinusitis (OR 0.90; 95%CI 0.86, 0.94; p < 0.001).
CONCLUSIONS CONCLUSIONS
Registrars' prescribing rates for sore throat, otitis media, and sinusitis significantly decreased during the period 2010-2019. However, educational (and other) interventions to further reduce prescribing are warranted.

Identifiants

DOI: 10.1093/fampra/cmad055 PMID: 37226282
pubmed: 37226282
pii: 7179275
doi: 10.1093/fampra/cmad055
pii:
doi:

Types de publication

Journal Article

Langues

eng

Sous-ensembles de citation

IM

Subventions

Organisme : Tropical Medical Training
Organisme : Synergy Regional Training Organisation
Organisme : Australian Department of Health and Aged Care
Organisme : Eastern Victoria General Practice Training
Organisme : General Practice Training Tasmania
Organisme : Australian Department of Health
Organisme : National Health and Medical Research Council
Organisme : Centre for Research Excellence in Minimising Antibiotic Resistance in the Community

Informations de copyright

© The Author(s) 2023. Published by Oxford University Press.

Auteurs

Alexandria Turner (A)

Faculty of Medicine, General Practice Clinical Unit, The University of Queensland, Brisbane, Australia.
NSW & ACT Research and Evaluation Unit, GP Synergy Regional Training Organisation, Newcastle, Australia.
ORCID: 0000-0002-8558-5321

Mieke L van Driel (ML)

Faculty of Medicine, General Practice Clinical Unit, The University of Queensland, Brisbane, Australia.
ORCID: 0000-0003-1711-9553

Benjamin L Mitchell (BL)

Faculty of Medicine, General Practice Clinical Unit, The University of Queensland, Brisbane, Australia.

Joshua S Davis (JS)

School of Medicine and Public Health, University of Newcastle, Callaghan, Australia.

Alison Fielding (A)

NSW & ACT Research and Evaluation Unit, GP Synergy Regional Training Organisation, Newcastle, Australia.
School of Medicine and Public Health, University of Newcastle, Callaghan, Australia.

Andrew Davey (A)

NSW & ACT Research and Evaluation Unit, GP Synergy Regional Training Organisation, Newcastle, Australia.
School of Medicine and Public Health, University of Newcastle, Callaghan, Australia.

Elizabeth Holliday (E)

School of Medicine and Public Health, University of Newcastle, Callaghan, Australia.

Jean Ball (J)

Clinical Research Design and Statistical Support Unit (CReDITSS), Hunter Medical Research Institute, New Lambton Heights, Australia.

Anna Ralston (A)

NSW & ACT Research and Evaluation Unit, GP Synergy Regional Training Organisation, Newcastle, Australia.
School of Medicine and Public Health, University of Newcastle, Callaghan, Australia.

Amanda Tapley (A)

NSW & ACT Research and Evaluation Unit, GP Synergy Regional Training Organisation, Newcastle, Australia.
School of Medicine and Public Health, University of Newcastle, Callaghan, Australia.

Katie Mulquiney (K)

NSW & ACT Research and Evaluation Unit, GP Synergy Regional Training Organisation, Newcastle, Australia.
School of Medicine and Public Health, University of Newcastle, Callaghan, Australia.

Emma J Baillie (EJ)

Faculty of Medicine, General Practice Clinical Unit, The University of Queensland, Brisbane, Australia.

Neil Spike (N)

Eastern Victoria General Practice Training, Regional Training Organisation, Hawthorn, Australia.
Department of General Practice and Primary Health Care, University of Melbourne, Carlton, Australia.
School of Rural Health, Monash University, Clayton, Australia.

Lisa Clarke (L)

General Practice Training Tasmania, Regional Training Organisation, Hobart, Australia.

Parker Magin (P)

NSW & ACT Research and Evaluation Unit, GP Synergy Regional Training Organisation, Newcastle, Australia.
School of Medicine and Public Health, University of Newcastle, Callaghan, Australia.
ORCID: 0000-0001-8071-8749

Classifications MeSH