Prescribing antibiotics: the use of diagnostic tests in general practice. A register-based study

Objective To assess (i) the pattern of antibiotic prescribing in Danish general practice, (ii) the use of diagnostic tests [point-of-care (POC) and tests analysed at the hospital laboratory (laboratory tests)], and (iii) the frequency of diagnostic testing in relation to antibiotic prescriptions. De...

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Autores principales:	Rikke Vognbjerg Sydenham, Ulrik Stenz Justesen, Malene Plejdrup Hansen, Line Bjørnskov Pedersen, Rune Munck Aabenhus, Sonja Wehberg, Dorte Ejg Jarbøl
Formato:	article
Lenguaje:	EN
Publicado:	Taylor & Francis Group 2021
Materias:	diagnostic methods drug prescription epidemiology family practice infections Public aspects of medicine RA1-1270
Acceso en línea:	https://doaj.org/article/1a2dfdec8e38444b853e3efaabcdb5f4
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spelling	oai:doaj.org-article:1a2dfdec8e38444b853e3efaabcdb5f42021-12-01T14:40:58ZPrescribing antibiotics: the use of diagnostic tests in general practice. A register-based study0281-34321502-772410.1080/02813432.2021.2004721https://doaj.org/article/1a2dfdec8e38444b853e3efaabcdb5f42021-11-01T00:00:00Zhttp://dx.doi.org/10.1080/02813432.2021.2004721https://doaj.org/toc/0281-3432https://doaj.org/toc/1502-7724Objective To assess (i) the pattern of antibiotic prescribing in Danish general practice, (ii) the use of diagnostic tests [point-of-care (POC) and tests analysed at the hospital laboratory (laboratory tests)], and (iii) the frequency of diagnostic testing in relation to antibiotic prescriptions. Design Retrospective cross-sectional register-based study. Setting General practice in a geographical area of Denmark covering 455,956 inhabitants. Subjects We studied redeemed antibiotic prescriptions and performed diagnostic tests in general practice from 2013 to 2017 among inhabitants in nine selected municipalities. Main outcome measures Frequency of antibiotic courses. Frequency and type of diagnostic testing performed in relation to types of antibiotics. Results A total of 783,252 antibiotic courses were redeemed from general practice with an overall decrease of 19% during 2013–2017. Diagnostic testing increased by 6% during this period. POC tests comprised the majority of performed diagnostic tests (83%) with C-reactive protein (CRP) as the most frequently used test. A 27% increase in the use of laboratory tests was observed. Tests were performed in relation to 43% of all antibiotic courses; most in relation to prescriptions for sulphonamide and trimethoprim (57%) and rarely when prescribing tetracyclines (10%). Conflicting with national guidelines, Danish GPs prescribed fluoroquinolones without performing any kind of diagnostic testing in 48% of the cases. Conclusions This study provides an overview of the use of diagnostic tests in relation to antibiotics and creates basis for further research into the variability between types of antibiotics. The study indicates that there is room for improvement to use diagnostic tests as an aid to promote prudent antibiotic use.KEY POINTS Diagnostic tests (point-of-care or tests analysed at the hospital laboratory), can increase diagnostic certainty and lead to a reduction in antibiotic use in general practice. A decrease in antibiotic courses in general practice in Denmark was observed during 2013–2017, while the use of diagnostic tests increased. A diagnostic test was performed in relation to 43% of antibiotic courses. Only 52% of prescribed fluoroquinolones was related to a diagnostic test, conflicting with national guidelines.Rikke Vognbjerg SydenhamUlrik Stenz JustesenMalene Plejdrup HansenLine Bjørnskov PedersenRune Munck AabenhusSonja WehbergDorte Ejg JarbølTaylor & Francis Grouparticlediagnostic methodsdrug prescriptionepidemiologyfamily practiceinfectionsPublic aspects of medicineRA1-1270ENScandinavian Journal of Primary Health Care, Vol 0, Iss 0, Pp 1-10 (2021)
institution	DOAJ
collection	DOAJ
language	EN
topic	diagnostic methods drug prescription epidemiology family practice infections Public aspects of medicine RA1-1270
spellingShingle	diagnostic methods drug prescription epidemiology family practice infections Public aspects of medicine RA1-1270 Rikke Vognbjerg Sydenham Ulrik Stenz Justesen Malene Plejdrup Hansen Line Bjørnskov Pedersen Rune Munck Aabenhus Sonja Wehberg Dorte Ejg Jarbøl Prescribing antibiotics: the use of diagnostic tests in general practice. A register-based study
description	Objective To assess (i) the pattern of antibiotic prescribing in Danish general practice, (ii) the use of diagnostic tests [point-of-care (POC) and tests analysed at the hospital laboratory (laboratory tests)], and (iii) the frequency of diagnostic testing in relation to antibiotic prescriptions. Design Retrospective cross-sectional register-based study. Setting General practice in a geographical area of Denmark covering 455,956 inhabitants. Subjects We studied redeemed antibiotic prescriptions and performed diagnostic tests in general practice from 2013 to 2017 among inhabitants in nine selected municipalities. Main outcome measures Frequency of antibiotic courses. Frequency and type of diagnostic testing performed in relation to types of antibiotics. Results A total of 783,252 antibiotic courses were redeemed from general practice with an overall decrease of 19% during 2013–2017. Diagnostic testing increased by 6% during this period. POC tests comprised the majority of performed diagnostic tests (83%) with C-reactive protein (CRP) as the most frequently used test. A 27% increase in the use of laboratory tests was observed. Tests were performed in relation to 43% of all antibiotic courses; most in relation to prescriptions for sulphonamide and trimethoprim (57%) and rarely when prescribing tetracyclines (10%). Conflicting with national guidelines, Danish GPs prescribed fluoroquinolones without performing any kind of diagnostic testing in 48% of the cases. Conclusions This study provides an overview of the use of diagnostic tests in relation to antibiotics and creates basis for further research into the variability between types of antibiotics. The study indicates that there is room for improvement to use diagnostic tests as an aid to promote prudent antibiotic use.KEY POINTS Diagnostic tests (point-of-care or tests analysed at the hospital laboratory), can increase diagnostic certainty and lead to a reduction in antibiotic use in general practice. A decrease in antibiotic courses in general practice in Denmark was observed during 2013–2017, while the use of diagnostic tests increased. A diagnostic test was performed in relation to 43% of antibiotic courses. Only 52% of prescribed fluoroquinolones was related to a diagnostic test, conflicting with national guidelines.
format	article
author	Rikke Vognbjerg Sydenham Ulrik Stenz Justesen Malene Plejdrup Hansen Line Bjørnskov Pedersen Rune Munck Aabenhus Sonja Wehberg Dorte Ejg Jarbøl
author_facet	Rikke Vognbjerg Sydenham Ulrik Stenz Justesen Malene Plejdrup Hansen Line Bjørnskov Pedersen Rune Munck Aabenhus Sonja Wehberg Dorte Ejg Jarbøl
author_sort	Rikke Vognbjerg Sydenham
title	Prescribing antibiotics: the use of diagnostic tests in general practice. A register-based study
title_short	Prescribing antibiotics: the use of diagnostic tests in general practice. A register-based study
title_full	Prescribing antibiotics: the use of diagnostic tests in general practice. A register-based study
title_fullStr	Prescribing antibiotics: the use of diagnostic tests in general practice. A register-based study
title_full_unstemmed	Prescribing antibiotics: the use of diagnostic tests in general practice. A register-based study
title_sort	prescribing antibiotics: the use of diagnostic tests in general practice. a register-based study
publisher	Taylor & Francis Group
publishDate	2021
url	https://doaj.org/article/1a2dfdec8e38444b853e3efaabcdb5f4
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Prescribing antibiotics: the use of diagnostic tests in general practice. A register-based study

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