Please use this identifier to cite or link to this item: http://hdl.handle.net/10553/75965
Title: C-reactive protein testing in patients with acute rhinosinusitis leads to a reduction in antibiotic use
Authors: Llor, Carl
Bjerrum, Lars
Arranz, Javier
Garcia-Blairsy Reina, Guillermo 
María Cots, Josep
Gonzalez López-Valcarcel, Beatriz 
Monedero, María José
Cuñarro Gómez, Manuel 
Ortega, Jesús 
Guerra De La Torre, María Gloria 
Cid, Marina
Paredes, Jose
Pineda, Vicenta
Perez, Carolina
de Dios Alcantara, Juan
Hernández Hellín, Silvia 
Keywords: Antibiotics
Audit
C-Reactive Protein
General Practice
Rational use of antibiotics, et al
Issue Date: 2012
Journal: Family Practice 
Abstract: To evaluate the effect of C-reactive protein (CRP) testing on the antibiotic prescribing in patients with acute rhinosinusitis.Audit-based study carried out in primary care centres in Spain. GPs registered episodes of rhinosinusitis during 3-week period before and after an intervention. Two types of intervention were considered: full intervention group (FIG) consisting in individual feedback based on results from the first registry, courses in rational antibiotic prescribing, guidelines, patient information leaflets, workshops on rapid tests and use of the CRP test. GPs in the partial intervention group (PIG) underwent all the above intervention except for the workshop and they did not have access to CRP. Multilevel logistic regression analysis was performed considering the prescription of antibiotics as the dependent variable.Two hundred and ten physicians were assigned to FIG and 71 to PIG. In 2009, 59 new physicians were included as a control group. Two hundred and sixty-seven GPs visited contacts with rhinosinusitis (78.5%) registering a total of 836 cases. In the group of GPs with access to CRP rapid test, 207 patients with rhinosinusitis (75.3%) were tested and antibiotics were prescribed in 156 patients (56.7%). Antibiotics were prescribed in 87 patients (82.9%) in the group of GPs exposed to PIG and in 52 patients (86.7%) in the control group (P < 0.001). Antibiotic prescription was significantly reduced after the intervention among physicians assigned to FIG, with an odds ratio of antibiotic prescribing of 0.12 (95% confidence interval: 0.01-0.32).Physicians with access to CRP tests significantly reduced antibiotic prescription in patients with rhinosinusitis.
URI: http://hdl.handle.net/10553/75965
ISSN: 0263-2136
DOI: 10.1093/fampra/cms026
Source: Family Practice [ISSN 0263-2136], v. 29 (6), p. 653-658, (Diciembre 2012)
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