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Indicators of the antibiotics prescription to treat of respiratory tract infections (RTI) in general practice

Authors:
  • Association of General Practitioners (Family medicine) of Russian Federation

Abstract and Figures

Result of the project European Committee « Health Alliance for prudent antibiotic prescribing in patients with respiratory tract infections» (HAPPY AUDIT), has showed: the use of method of medical internal audit (APO method) and implementing the Point of Care (POC) tests: Strep A antigen test and C-reactive protein test (CRP) in general practice may lead to a reduction in antibiotic prescribing to patients with RTIs and may lead to decrease of bacterial resistance to antibiotics.
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.9
CONTENTS
FEATURE STORY:
HYPERTENSION
Kolbasnikov
5.V.,
Belova
N.0., Mokunin
A.A., Rodionov
A.4.,
Melnikova A.A.
The connection between
the
parameters
of
pulse
wave, bioelectrical
brain
activity and
emotional
state of
patients
with hypertension.......... ...................3
Sigitova
0.N., Saubanova
E.1.,
Arhipov E.V.
The analysis of
membranes
destabilization
at
patients
with
a
hypertonic
disease
with a
hypertensive
nephropathy............... .........9
REGIONAL
HEALTHCARE
Mikhaylin A.l.
Epidemiology of
osteoporosis
in KHMA0-Yugra............... .................19
Gorshunova
N.K.,
Medvedev
N.V.,
Podpryatova
T.V.
Risk of death
assessment
in elderly
patients
with
chronic
heart
failure in
the
general practice... ...............'.'38
Roytberg G.E., Slastnikova
LD.
Assessment of
heart
rate
in
patients
with
permanent
atrialfibrillation:
comparison
of standard
ECG and
Holter
monitoring ..................42
Bolotnova
7.V., Platitsyna
N. G.,
Kuslivaya 0.
N.
Features osteopenic
syndrome
in
patients
with
chronic non-communicable
diseases
(cardiovascularandbroncho-obstructivepathology)
Reutskiy A.A.,
Bjerrum
L.,
Munck
A.,
Gahrn-Hansen
8., Hansen
M.P.,
Lopez-Valkarsel
8.G., Caballero
L., Radzeviciene
R., Llor C.,
Strandberg
E.L.,}vhead
1., Lionis
Ch.
Indicators
of
the antibiotics
prescription
to treat
of
respiratorytract
infections
(RTl)
in
general practice ......................56
Babanov
5.A.,
Tatarovskaya
N.A.
Professional chro
nic I u
mbosacral
radiculopathy.............
PREVENTION AND
REHABILITATION
Napalkov
D.A., So4olova
A.A.
Modern approaches
to
the stroke
prevention
in
patients
with atrialtibrillation
and
practical
aspects
of dabigatran's
application
...................................72
CHILD AND
ADOLESCENT
HEALTH
Zaika G.E.
ls
there
a connection
between
the disturbances
ante- and
perinatal
development
and
by
the formation
of
the highest mental
and intellectual
functions
in children and
adolescents of
school age?........... .......81
PERSONNEL
MAfiERS
Katkasova L.G.
Evaluation of
labor
potential
of nurses
(fragment
of
research) ..........87
OFFICIALLY
Commentary of
the
Russian
Ministry of,health on
rural medicine..... ...................,91
Xypuan
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{HAPPY
AUDIT!,
hag *ho$td,:
he-!s€ ol method
of modical
intamal audit
(Ap0
m0thod)
and implgmsnting
tis Poi$t
ot Ciro
{Pm) t6fri $fep A rtdigen t€st and
C-reactivs
proiein
tsst
(oRP)
In
0snsral
pra0tlce
may l6ad
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AUDIT) // B}..fC Family Practice - 2Ot0;
DOI: 10.
1 186
/ L47
L-2296-Lt-29.
5. Llor C., Bjerrurn L., et al. C-reactive
protein testing in patients with acute
rhinosinusitis leads to a reduction in
antibiotic use. BMC Family Practice.
20L2.
- Nb 29.
- P. 653-658.
6. Llor C., Bjerru.m L., et al. Predictors
for antibiotic prescribing in patients with
exacerbations of COPD in general pra-
ctice / / Therapeutic Advances in Respi-
ratory Disease - 2013. - VoI. 7. - ].J! 3. -
P. 131-137.
7. Munch 4.P., et al. The APO method
a popular form of quality development in
general
practice //Ugeskr Laeger. - 2002. -
Vol. 164. - P. 5390-5393.
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Article
Full-text available
Background: The aim of this study was to describe the antibiotic prescribing rate in patients with acute exacerbation of chronic obstructive pulmonary disease (AECOPD), to analyse predictors for antibiotic prescribing and to explore the influence of the use C-reactive protein (CRP) rapid test. Methods: A cross-sectional study was carried out in January and February 2008 in primary care. General practitioners (GPs) from six countries (Denmark, Sweden, Lithuania, Russia, Spain and Argentina) registered all patients with AECOPD during a 3-week period. A multilevel logistic regression model was estimated using two hierarchical levels, (i) patients and (ii) physicians, and was used to analyse the association between antibiotic prescribing and potential predictors for antibiotic use: patients' age and gender, duration and symptoms and signs of exacerbations (fever, cough, dyspnoea, sputum volume and purulence) and the results of the CRP test. Results: A total of 617 GPs registered 1233 patients with AECOPD. A total of 970 patients (79%) were prescribed antibiotics, varying from 49% (Denmark) to 93% (Russia). The presence of purulent sputum was the strongest predictor for antibiotic treatment (odds ratio [OR] 8.7; 95% confidence interval [CI] 5.9-12.8). CRP determination was carried out mainly in Denmark and Sweden and its use was the strongest protective factor for antibiotic therapy (OR 0.3; 95% CI 0.2-0.6). GPs that used CRP testing weighted purulent sputum lower than GPs who did not use CRP testing. CRP values had a strong influence on the antibiotic prescribing rate. Conclusions: Antibiotic treatment for AECOPD is very high. This study shows that GPs performing CRP rapid tests prescribe fewer antibiotics than those who do not.
C-reactive protein testing in patients with acute rhinosinusitis leads to a reduction in antibiotic use
  • C Llor
  • L Bjerrurn
Llor C., Bjerrurn L., et al. C-reactive protein testing in patients with acute rhinosinusitis leads to a reduction in antibiotic use. BMC Family Practice. 20L2.-Nb 29.-P. 653-658.
C-reactive Family Practice. 20L2. -Nb 29
  • C Llor
  • L Bjerrurn
Llor C., Bjerrurn L., et al. C-reactive Family Practice. 20L2. -Nb 29. -P. 653-658.