Efficacy and safety of discontinuing antibiotic treatment for uncomplicated respiratory tract infections when deemed unnecessary. A multicentre, randomized clinical trial in primary care

Antibacterial agent; Antibiotic stewardship; Primary health care

Detalles Bibliográficos
Autores: Moragas, Ana, Bayona, Carolina, Cots, Josep M., Hernandez, Silvia, Calviño, Olga, Rodríguez, Migdalia, Miravitlles Fernández, Marc, Llor, Carl
Tipo de recurso: artículo
Estado:Versión publicada
Fecha de publicación:2021
País:España
Institución:Departament de Salut de la Generalitat de Catalunya (DS)
Repositorio:Scientia. Dipòsit d'Informació Digital del Departament de Salut
OAI Identifier:oai:scientiasalut.gencat.cat:11351/7813
Acceso en línea:https://hdl.handle.net/11351/7813
Access Level:acceso abierto
Palabra clave:Infeccions respiratòries - Tractament
Avaluació de resultats (Assistència sanitària)
Medicaments antibacterians
DISEASES::Bacterial Infections and Mycoses::Infection::Respiratory Tract Infections
Other subheadings::Other subheadings::Other subheadings::/drug therapy
ENFERMEDADES::infecciones bacterianas y micosis::infección::infecciones del tracto respiratorio
Otros calificadores::Otros calificadores::Otros calificadores::/farmacoterapia
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oai_identifier_str oai:scientiasalut.gencat.cat:11351/7813
network_acronym_str ES
network_name_str España
repository_id_str
dc.title.none.fl_str_mv Efficacy and safety of discontinuing antibiotic treatment for uncomplicated respiratory tract infections when deemed unnecessary. A multicentre, randomized clinical trial in primary care
title Efficacy and safety of discontinuing antibiotic treatment for uncomplicated respiratory tract infections when deemed unnecessary. A multicentre, randomized clinical trial in primary care
spellingShingle Efficacy and safety of discontinuing antibiotic treatment for uncomplicated respiratory tract infections when deemed unnecessary. A multicentre, randomized clinical trial in primary care
Moragas, Ana
Infeccions respiratòries - Tractament
Avaluació de resultats (Assistència sanitària)
Medicaments antibacterians
DISEASES::Bacterial Infections and Mycoses::Infection::Respiratory Tract Infections
Other subheadings::Other subheadings::Other subheadings::/drug therapy
ENFERMEDADES::infecciones bacterianas y micosis::infección::infecciones del tracto respiratorio
Otros calificadores::Otros calificadores::Otros calificadores::/farmacoterapia
title_short Efficacy and safety of discontinuing antibiotic treatment for uncomplicated respiratory tract infections when deemed unnecessary. A multicentre, randomized clinical trial in primary care
title_full Efficacy and safety of discontinuing antibiotic treatment for uncomplicated respiratory tract infections when deemed unnecessary. A multicentre, randomized clinical trial in primary care
title_fullStr Efficacy and safety of discontinuing antibiotic treatment for uncomplicated respiratory tract infections when deemed unnecessary. A multicentre, randomized clinical trial in primary care
title_full_unstemmed Efficacy and safety of discontinuing antibiotic treatment for uncomplicated respiratory tract infections when deemed unnecessary. A multicentre, randomized clinical trial in primary care
title_sort Efficacy and safety of discontinuing antibiotic treatment for uncomplicated respiratory tract infections when deemed unnecessary. A multicentre, randomized clinical trial in primary care
dc.creator.none.fl_str_mv Moragas, Ana
Bayona, Carolina
Cots, Josep M.
Hernandez, Silvia
Calviño, Olga
Rodríguez, Migdalia
Miravitlles Fernández, Marc
Llor, Carl
author Moragas, Ana
author_facet Moragas, Ana
Bayona, Carolina
Cots, Josep M.
Hernandez, Silvia
Calviño, Olga
Rodríguez, Migdalia
Miravitlles Fernández, Marc
Llor, Carl
author_role author
author2 Bayona, Carolina
Cots, Josep M.
Hernandez, Silvia
Calviño, Olga
Rodríguez, Migdalia
Miravitlles Fernández, Marc
Llor, Carl
author2_role author
author
author
author
author
author
author
dc.contributor.none.fl_str_mv Institut Català de la Salut
[Llor C] Department of Public Health, General Practice, University of Southern Denmark, Odense, Denmark. University Institute in Primary Care Research Jordi Gol, Via Roma Health Centre, Barcelona, Spain. [Moragas A] Universitat Rovira i Virgili. Jaume I Health Centre, Tarragona, Spain. [Bayona C, Rodríguez M] Primary Healthcare Centre La Marina, Barcelona, Spain. [Cots JM] Universitat of Barcelona, Primary Healthcare Centre La Marina, Barcelona, Spain. [Hernández S, Calviño O] Primary Healthcare Centre Jaume I, Tarragona, Spain. [Miravitlles M] Servei de Pneumologia, Vall d'Hebron Hospital Universitari, Barcelona, Spain. Vall d'Hebron Institut de Recerca (VHIR), Barcelona, Spain. CIBER de Enfermedades Respiratorias (CIBERES), Barcelona, Spain
Vall d'Hebron Barcelona Hospital Campus
dc.subject.none.fl_str_mv Infeccions respiratòries - Tractament
Avaluació de resultats (Assistència sanitària)
Medicaments antibacterians
DISEASES::Bacterial Infections and Mycoses::Infection::Respiratory Tract Infections
Other subheadings::Other subheadings::Other subheadings::/drug therapy
ENFERMEDADES::infecciones bacterianas y micosis::infección::infecciones del tracto respiratorio
Otros calificadores::Otros calificadores::Otros calificadores::/farmacoterapia
topic Infeccions respiratòries - Tractament
Avaluació de resultats (Assistència sanitària)
Medicaments antibacterians
DISEASES::Bacterial Infections and Mycoses::Infection::Respiratory Tract Infections
Other subheadings::Other subheadings::Other subheadings::/drug therapy
ENFERMEDADES::infecciones bacterianas y micosis::infección::infecciones del tracto respiratorio
Otros calificadores::Otros calificadores::Otros calificadores::/farmacoterapia
description Antibacterial agent; Antibiotic stewardship; Primary health care
publishDate 2021
dc.date.none.fl_str_mv 2021
2022
2022
2022
dc.type.none.fl_str_mv info:eu-repo/semantics/article
info:eu-repo/semantics/publishedVersion
format article
status_str publishedVersion
dc.identifier.none.fl_str_mv https://hdl.handle.net/11351/7813
url https://hdl.handle.net/11351/7813
dc.language.none.fl_str_mv Inglés
language_invalid_str_mv Inglés
dc.relation.none.fl_str_mv Clinical Microbiology and Infection;28(2)
https://doi.org/10.1016/j.cmi.2021.07.035
dc.rights.none.fl_str_mv Attribution 4.0 International
http://creativecommons.org/licenses/by/4.0/
info:eu-repo/semantics/openAccess
rights_invalid_str_mv Attribution 4.0 International
http://creativecommons.org/licenses/by/4.0/
eu_rights_str_mv openAccess
dc.format.none.fl_str_mv application/pdf
dc.publisher.none.fl_str_mv Elsevier
publisher.none.fl_str_mv Elsevier
dc.source.none.fl_str_mv Scientia
reponame:Scientia. Dipòsit d'Informació Digital del Departament de Salut
instname:Departament de Salut de la Generalitat de Catalunya (DS)
instname_str Departament de Salut de la Generalitat de Catalunya (DS)
reponame_str Scientia. Dipòsit d'Informació Digital del Departament de Salut
collection Scientia. Dipòsit d'Informació Digital del Departament de Salut
repository.name.fl_str_mv
repository.mail.fl_str_mv
_version_ 1869414461256761344
spelling Efficacy and safety of discontinuing antibiotic treatment for uncomplicated respiratory tract infections when deemed unnecessary. A multicentre, randomized clinical trial in primary careMoragas, AnaBayona, CarolinaCots, Josep M.Hernandez, SilviaCalviño, OlgaRodríguez, MigdaliaMiravitlles Fernández, MarcLlor, CarlInfeccions respiratòries - TractamentAvaluació de resultats (Assistència sanitària)Medicaments antibacteriansDISEASES::Bacterial Infections and Mycoses::Infection::Respiratory Tract InfectionsOther subheadings::Other subheadings::Other subheadings::/drug therapyENFERMEDADES::infecciones bacterianas y micosis::infección::infecciones del tracto respiratorioOtros calificadores::Otros calificadores::Otros calificadores::/farmacoterapiaAntibacterial agent; Antibiotic stewardship; Primary health careAgente antibacteriano; Administración de antibióticos; Atención primaria de saludAgent antibacterià; Administració d'antibiòtics; Atenció primària de salutObjectives To determine the benefits and harms of discontinuing unnecessary antibiotic therapy for uncomplicated respiratory tract infections (RTI) when antibiotics are considered no longer necessary. Methods Multicentre, open-label, randomized controlled clinical trial in primary care centres from 2017 to 2020 (ClinicalTrials.gov, NCT02900820). Adults with RTIs—acute rhinosinusitis, sore throat, influenza or acute bronchitis—who had previously taken any dose of antibiotic for less than 3 days, which physicians no longer deemed necessary were recruited. The patients were randomly assigned in a 1:1 ratio to discontinuing antibiotic therapy or the usual strategy of continuing antibiotic treatment. The primary outcome was the duration of severe symptoms (number of days scoring 5 or 6 on a six-item Likert scale). Secondary outcomes included days with symptoms, moderate symptoms (scores of 3 or 4), antibiotics taken, adverse events, patient satisfaction and complications within the first 3 months. Results A total of 467 patients were randomized, out of which 409 were considered valid for the analysis. The mean (SD) duration of severe symptoms was 3.0 (1.5) days for the patients assigned to discontinuation and 2.8 (1.3) days for those allocated to the control group (mean difference 0.2 days; 95% CI –0.1 to 0.4 days). Patients randomized to the discontinuation group used fewer antibiotics after the baseline visit (52/207 (25.1%) versus 182/202 (90.1%); p 0.001). Patients assigned to antibiotic continuation presented a relative risk of adverse events of 1.47 (95% CI 0.80–2.71), but the need for further health-care contact in the following 3 months was slightly lower (RR 0.61; 95% CI 0.28–1.37). Conclusions Discontinuing antibiotic treatment for uncomplicated RTIs when clinicians consider it unnecessary is safe and notably reduces antibiotic consumption.This work was supported by the Catalan Society of Family Medicine, grant number FAP1601. The funder of the study had no role in study design, data collection, data analysis, data interpretation, or writing of the report. This trial was registered with the ClinicalTrials.gov database (Identifier: NCT02900820).ElsevierInstitut Català de la Salut[Llor C] Department of Public Health, General Practice, University of Southern Denmark, Odense, Denmark. University Institute in Primary Care Research Jordi Gol, Via Roma Health Centre, Barcelona, Spain. [Moragas A] Universitat Rovira i Virgili. Jaume I Health Centre, Tarragona, Spain. [Bayona C, Rodríguez M] Primary Healthcare Centre La Marina, Barcelona, Spain. [Cots JM] Universitat of Barcelona, Primary Healthcare Centre La Marina, Barcelona, Spain. [Hernández S, Calviño O] Primary Healthcare Centre Jaume I, Tarragona, Spain. [Miravitlles M] Servei de Pneumologia, Vall d'Hebron Hospital Universitari, Barcelona, Spain. Vall d'Hebron Institut de Recerca (VHIR), Barcelona, Spain. CIBER de Enfermedades Respiratorias (CIBERES), Barcelona, SpainVall d'Hebron Barcelona Hospital Campus2022202220212022info:eu-repo/semantics/articleinfo:eu-repo/semantics/publishedVersionapplication/pdfhttps://hdl.handle.net/11351/7813Scientiareponame:Scientia. Dipòsit d'Informació Digital del Departament de Salutinstname:Departament de Salut de la Generalitat de Catalunya (DS)InglésClinical Microbiology and Infection;28(2)https://doi.org/10.1016/j.cmi.2021.07.035Attribution 4.0 Internationalhttp://creativecommons.org/licenses/by/4.0/info:eu-repo/semantics/openAccessoai:scientiasalut.gencat.cat:11351/78132026-06-12T09:38:37Z
score 15,198674

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