Microbiological point of care testing before antibiotic prescribing in primary care: considerable variations between practices.
BMC Fam Pract
; 18(1): 9, 2017 01 26.
Article
em En
| MEDLINE
| ID: mdl-28125965
ABSTRACT
BACKGROUND:
Point-of-care testing (POCT) in primary care may improve rational antibiotic prescribing. We examined use of POCT in Denmark, including patient- and general practitioner (GP)-related predictors.METHODS:
We linked nationwide health care databases to assess POCT use (C-reactive protein (CRP), group A streptococcal (GAS) antigen swabs, bacteriological cultures, and urine test strips) per 1,000 overall GP consultations, 2004-2013. We computed odds ratios (OR) of POCT in patients prescribed antibiotics according to patient and GP age and sex, GP practice type, location, and workload.RESULTS:
The overall use of POCT in Denmark increased by 45.8% during 2004-2013, from 147.2 per 1,000 overall consultations to 214.8. CRP tests increased by 132%, bacteriological cultures by 101.7% while GAS swabs decreased by 8.6%. POCT preceded 28% of antibiotic prescriptions in 2004 increasing to 44% in 2013. The use of POCT varied more than 5-fold among individual practices, from 54.9 to 394.7 per 1,000 consultations in 2013. POCT use varied substantially with patient age, and males were less likely to receive POCT than females (adjusted OR = 0.75, 95% CI 0.74-0.75) driven by usage of urine test strips among females (18% vs. 7%). Odds of POCT were higher among female GPs and decreased with higher GP age, with lowest usage among male GPs >60 years. GP urban/rural location and workload had little impact.CONCLUSION:
GPs use POCT increasingly with the highest use among young female GPs. In 2013, 44% of all antibiotic prescriptions were preceded by POCT but testing rates vary greatly across individual GPs.Palavras-chave
Texto completo:
1
Base de dados:
MEDLINE
Assunto principal:
Atenção Primária à Saúde
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Infecções Estreptocócicas
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Infecções Bacterianas
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Infecções Urinárias
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Padrões de Prática Médica
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Faringite
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Clínicos Gerais
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Testes Imediatos
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Antibacterianos
Tipo de estudo:
Diagnostic_studies
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Observational_studies
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Prevalence_studies
/
Prognostic_studies
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Risk_factors_studies
Limite:
Adolescent
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Adult
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Aged
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Aged80
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Child
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Child, preschool
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Female
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Humans
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Infant
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Male
País/Região como assunto:
Europa
Idioma:
En
Revista:
BMC Fam Pract
Ano de publicação:
2017
Tipo de documento:
Article
País de afiliação:
Dinamarca