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Delayed antibiotic prescribing in primary care: a randomized prospective interventional study evaluating antibiotic consumption according to the modalities of prescription in the routine practice of general practitioners Volume 17, issue 8, Octobre 2021

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Authors
1 Interne en médecine générale, 10800 Saint-Julien-les-Villas, France
2 Interne en médecine générale, Bordeaux, France
3 Professeur associé de médecine générale, Département de Médecine Générale, 146 rue Léo Saignat CS 61292, 33 076 Bordeaux cedex, France
* Correspondance

Background: Antibiotic resistance is a major public health issue. Most antibiotics are prescribed by general practitioners for pathologies that rarely require antibiotic therapy. Delayed antibiotic prescription (DAP) is an alternative way to reduce antibiotic consumption.

Methods: Prospective, interventional, quantitative study of two parallel groups of general practitioners accustomed to the practice of DAP in France. The primary outcome was the rate of antibiotic consumption by the patient according to group (protocolized DAP or usual DAP). The protocolized DAP group had to stick a label on the prescription. The label included information for the patient on the conditions for taking the antibiotic and the delay before taking it.

Results: 205 DAPs were analyzed. Antibiotic consumption in the labelled group (40.7%) was lower than in the unlabeled group (51.9%) (P = 0.11). We performed a second comparison by separating DAPs with oral modalities only (on which there were no written indications on the DAP) and DAPs with written modalities. Antibiotic consumption with written modalities (43.7%) was lower than that with oral modality alone (52.4%) (P = 0.25). In our study 42 out of 137 (30.7%) patients went to the pharmacy to get the antibiotics but did not consume it

Conclusion: Our results show a tendency towards a decrease in antibiotic consumption after written instructions in physicians accustomed to performing DAP. Regardless of the prescribing methods used by general practitioners accustomed to this practice, antibiotic consumption decreased if the information transmitted is clear and appropriate.