基层医生在治疗咽痛和下呼吸道感染中使用即时检测和开具抗生素的情况。
Use of point-of-care tests and antibiotic prescribing in sore throat and lower respiratory infections by general practitioners.
机构信息
University Institute in Primary Care Research Jordi Gol, Via Roma Health Centre, Barcelona, Spain; Section of General Practice and Research Unit for General Practice, Department of Public Health, University of Copenhagen, Copenhagen, Denmark.
San Andrés Health Centre, Madrid, Spain.
出版信息
Enferm Infecc Microbiol Clin (Engl Ed). 2020 Jan;38(1):21-24. doi: 10.1016/j.eimc.2019.02.005. Epub 2019 Apr 10.
INTRODUCTION
This study was aimed at assessing general practitioners' (GP) reliance on patient history, examination findings and the influence of the utilisation of point-of-care tests (POCT) in antibiotic prescribing for sore throat and lower respiratory tract infections (LRTI).
METHODS
Audit-based study carried out in 2015. A group of GPs received an intervention six years earlier with provision of POCTs and another group of GPs acted as controls. Odds ratios for clinical variables predicting antibiotic prescribing were calculated by logistic regression analyses.
RESULTS
A total of 238 GPs included 1906 patients with sore throat and 1970 LRTIs. A negative POCT result was negatively associated with antibiotic prescribing, with odds ratios ranging from 0.09 to 0.23. GPs using POCTs attached less weight to clinical criteria.
CONCLUSION
GPs using rapid tests are mainly influenced by POCT results in the decision to prescribe antibiotics. However, antibiotic prescribing is still observed with negative POCT results.
简介
本研究旨在评估全科医生（GP）在治疗喉咙痛和下呼吸道感染（LRTI）时对患者病史、检查结果的依赖程度，以及即时检测（POCT）的使用对开具抗生素处方的影响。
方法
2015 年进行了基于审核的研究。一组 GP 在六年前接受了干预，提供了 POCT，另一组 GP 作为对照组。通过逻辑回归分析计算预测抗生素处方的临床变量的比值比。
结果
共纳入 238 名 GP 和 1906 例喉咙痛患者和 1970 例 LRTI 患者。POCT 检测结果呈阴性与抗生素处方呈负相关，比值比范围为 0.09 至 0.23。使用 POCT 的 GP 对临床标准的重视程度降低。
结论
使用快速检测的 GP 主要受 POCT 结果影响，从而决定是否开具抗生素处方。然而，即使 POCT 结果为阴性，仍会开出抗生素处方。
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