[Antibiotic prescribing in respiratory tract infections and predictive factors for their use]. / Prescripción de antibióticos en las infecciones del tracto respiratorio y factores predictores de su utilización.

OBJECTIVE: Happy Audit project is a European-funded survey aimed at reducing antibiotic prescribing for respiratory tract infections (RTI). The aim of this study is to investigate the antibiotic treatment administered for these RTIs in Spain and to find out which criteria are associated with its use. DESIGN: Cross-sectional study carried out in January and February 2008. SETTING: Primary health care. PARTICIPANTS: General practitioners registered all the RTI during a 3-week period using a template. PRINCIPAL MEASUREMENTS: Age and gender, days with symptoms, signs presented (fever, cough, purulent ear discharge, sore throat, tonsillar exudate, swollen neck glands, dyspnoea, increase in sputum, purulent sputum), diagnosis, antibiotic therapy and demand of antibiotics. A logistic regression with the prescription of antibiotic as the dependent variable was performed. RESULTS: Out of the 332 physicians invited to participate, 309 filled in and returned the templates (93.1%), registering 16,751 RTIs, with the common cold (39.7%), pharyngitis (14.4%) and acute bronchitis (12.6%) being the most common. Antibiotic therapy was given to 4,675 RTIs (27.9%), mainly for pneumonia (89.9%), tonsillitis (88.9%), and otitis media (87.3%). The criterion most associated with antibiotic therapy was the presence of tonsillar exudate (OR: 32.1; 95CI%: 24.5-42), followed by ear discharge (25.2; 95%CI: 18.2-35) and purulence of sputum (18.1; 95%CI: 15.5-21.2); conversely, cough (OR: 0.4; 95%CI: 0.3-0.5) was considered as protective factor. DISCUSSION: Antibiotic treatment for RTIs is very high in our country. This study provides information on the criteria that predict this antibiotic therapy and is important to take into account if a more rational use of antibiotics is required.

Prescripción de antibióticos en las infecciones del tracto respiratorio y factores predictores de su utilización / Antibiotic prescribing in respiratory tract infections and predictive factors for their use

ObjetivoEl estudio Happy Audit es un proyecto financiado por la Comunidad Europea, y tiene por objetivo mejorar la prescripción antibiótica en las infecciones del tracto respiratorio (ITR). Se realizó el presente estudio para conocer el tratamiento antibiótico administrado en las ITR en España y conocer qué criterios se asocian a su prescripción.DiseñoEstudio transversal realizado en enero y febrero de 2008.EmplazamientoCentros de atención primaria.ParticipantesMédicos de atención primaria de España que registraron durante 3 semanas todas las ITR mediante una plantilla.Mediciones principalesEdad y sexo, días con síntomas, signos presentes (fiebre, tos, otorrea purulenta, odinofagia, exudado amigdalar, adenopatías cervicales, disnea, aumento de esputo, esputo purulento), diagnóstico, tratamiento antibiótico y demanda de antibiótico. Se efectuó regresión logística y se consideró como variable dependiente la prescripción antibiótica.ResultadosDe los 332 médicos a los que se invitó a participar, 309 (93,1%) rellenaron los registros. Se registraron 16.751 ITR; las más frecuentes fueron el resfriado (39,7%), la faringitis (14,4%) y la bronquitis aguda (12,6%). Se prescribieron antibióticos en 4.675 ITR (27,9%), principalmente en neumonía (89,9%), amigdalitis (88,9%) y otitis media (87,3%). El criterio que más se asoció a prescripción antibiótica fue la presencia de exudado amigdalar (odds ratio [OR] de 32,1; intervalo de confianza [IC] del 95%: 24,5 a 42), seguido de otorrea (OR de 25,2; IC del 95%: 18,2 a 35) y esputo purulento (OR de 18,1; IC del 95%: 15,5 a 21,2); en cambio, fue protectora la tos (OR de 0,4; IC del 95%: 0,3 a 0,5).DiscusiónLa prescripción antibiótica en las ITR es muy elevada en España. Este estudio aporta información sobre factores predictores de tratamiento antibiótico fundamental para promover un uso más racional de antibióticos(AU)

ObjectiveHappy Audit project is a European-funded survey aimed at reducing antibiotic prescribing for respiratory tract infections (RTI). The aim of this study is to investigate the antibiotic treatment administered for these RTIs in Spain and to find out which criteria are associated with its use.DesignCross-sectional study carried out in January and February 2008.SettingPrimary health care.ParticipantsGeneral practitioners registered all the RTI during a 3-week period using a template.Principal measurementsAge and gender, days with symptoms, signs presented (fever, cough, purulent ear discharge, sore throat, tonsillar exudate, swollen neck glands, dyspnoea, increase in sputum, purulent sputum), diagnosis, antibiotic therapy and demand of antibiotics. A logistic regression with the prescription of antibiotic as the dependent variable was performed.ResultsOut of the 332 physicians invited to participate, 309 filled in and returned the templates (93.1%), registering 16,751 RTIs, with the common cold (39.7%), pharyngitis (14.4%) and acute bronchitis (12.6%) being the most common. Antibiotic therapy was given to 4,675 RTIs (27.9%), mainly for pneumonia (89.9%), tonsillitis (88.9%), and otitis media (87.3%). The criterion most associated with antibiotic therapy was the presence of tonsillar exudate (OR: 32.1; 95CI%: 24.5–42), followed by ear discharge (25.2; 95%CI: 18.2–35) and purulence of sputum (18.1; 95%CI: 15.5–21.2); conversely, cough (OR: 0.4; 95%CI: 0.3–0.5) was considered as protective factor.DiscussionAntibiotic treatment for RTIs is very high in our country. This study provides information on the criteria that predict this antibiotic therapy and is important to take into account if a more rational use of antibiotics is required(AU)