Estimated saving of antibiotics in pharyngitis and lower respiratory tract infections if general practitioners had rapid tests and followed guidelines

Abstract

Introduction: General practitioners (GP) in Spain do not have access to rapid tests and adherence to guidelines is usually suboptimal. The aim of the study is to evaluate the estimated number of antibiotics that could have been saved if GPs had appropriately used these tests and had followed the guidelines. Design: Observational study. Setting: Primary care centres from eight Autonomous Communities in Spain. Participants: GPs who had not participated in previous studies on rational use of antibiotics. Intervention: GPs registered all the cases of pharyngitis and lower respiratory tract infections (LRTI) during 15 working days in 2015, by means of a 47-item audit. Main measurements: Actual GPs’ antibiotic prescription and estimated number of antibiotics that could have been saved according to recent guidelines. Results: A total of 126 GPs registered 1012 episodes of pharyngitis and 1928 LRTIs. Antibiotics were given or patients were referred in 497 patients with pharyngitis (49.1%) and 963 patients with LRTI (49.9%). If GPs had appropriately used rapid antigen detection tests and C-reactive protein tests and had strictly followed current guidelines, antibiotics would have been given to 7.6% and 15.1%, respectively, with an estimated saving of 420 antibiotics in patients with sore throat (estimated saving of 84.5%; 95% CI: 81.1---87.4%) and 672 antibiotics in LRTIs (estimated saving of 69.8%,95% CI: 67.1---72.5%).