Rationale, design and organization of the delayed antibiotic prescription (DAP) trial: a randomized controlled trial of the efficacy and safety of delayed antibiotic prescribing strategies in the non-complicated acute respiratory tract infections in general practice

BMC Family Practice

Study Protocol

Paul Little¹  Mariam de la Poza Abad²  Antonio Negrete Palma³  Silvia Hernández Anadón⁴  Carl LLor⁴  Eulàlia Borrell Thió⁵  Rafael Rotaeche del Campo⁶  Mikel Moreno Bakedano⁷  Yolanda Canellas Criado⁸  Ana Isabel González González⁹  Gemma Mas Dalmau^1,10  Pablo Alonso Coello^1,11  Guillem Pera^1,12  Pere Torán Monserrat^1,13 

[1] Aldermoor Health Centre, Aldermoor Close, Southhampton, UK;Centro de Atención Primaria Doctor Carles Ribas, Barcelona, Spain;Centro de Atención Primaria El Maresme, Mataró, Spain;Centro de Atención Primaria Jaume I, Tarragona, Spain;Centro de Atención Primaria Sant Roc, Badalona, Spain;Centro de Salud Alza Osakidetza, Grupo Kronikgune sobre gestión del conocimiento, Donostia, Spain;Grupo de Medicina Basada en la Evidencia de SemFYC, Madrid, Spain;Centro de Salud Irutzun, Irurtzun, Spain;Centro de Salud Monóvar, Madrid, Spain;Centro de Salud Vicente Muzas, Madrid, Spain;Iberoamerican Cochrane Centre, Biomedical Research Institute Sant Pau (IIB Sant Pau), Sant Antonio Ma Claret 167, 08025, Barcelona, Spain;Iberoamerican Cochrane Centre, Biomedical Research Institute Sant Pau (IIB Sant Pau), Sant Antonio Ma Claret 167, 08025, Barcelona, Spain;Grupo de Medicina Basada en la Evidencia de SemFYC, Madrid, Spain;Unitat de Suport a la Recerca Metropolitana Nord, Institut Universitari d’Investigació en Atenció Primària Jordi Gol (IDIAP Jordi Gol), Santa Coloma de Gramenet, Spain;Unitat de Suport a la Recerca Metropolitana Nord, Institut Universitari d’Investigació en Atenció Primària Jordi Gol (IDIAP Jordi Gol), Santa Coloma de Gramenet, Spain;Centro de Atención Primaria El Maresme, Mataró, Spain;

关键词: Delayed antibiotic prescription;    Respiratory infections;    Family medicine;    Pharyngitis;    Acute tonsillitis;    Rhinosinusitis;    Acute bronchitis;    Chronic obstructive pulmonary disease;   

DOI  :  10.1186/1471-2296-14-63

 received in 2013-03-27, accepted in 2013-05-10,  发布年份 2013

来源: Springer

【 摘 要 】

BackgroundRespiratory tract infections are an important burden in primary care and it’s known that they are usually self-limited and that antibiotics only alter its course slightly. This together with the alarming increase of bacterial resistance due to increased use of antimicrobials calls for a need to consider strategies to reduce their use. One of these strategies is the delayed prescription of antibiotics.MethodsMulticentric, parallel, randomised controlled trial comparing four antibiotic prescribing strategies in acute non-complicated respiratory tract infections. We will include acute pharyngitis, rhinosinusitis, acute bronchitis and acute exacerbation of chronic bronchitis or chronic obstructive pulmonary disease (mild to moderate). The therapeutic strategies compared are: immediate antibiotic treatment, no antibiotic treatment, and two delayed antibiotic prescribing (DAP) strategies with structured advice to use a course of antibiotics in case of worsening of symptoms or not improving (prescription given to patient or prescription left at the reception of the primary care centre 3 days after the first medical visit).DiscussionDelayed antibiotic prescription has been widely used in Anglo-Saxon countries, however, in Southern Europe there has been little research about this topic. The DAP trial wil evaluate two different delayed strategies in Spain for the main respiratory infections in primary care.Trial registrationThis trial is registered with ClinicalTrials.gov, number http://NCT01363531.

【 授权许可】

Unknown   
© de la Poza Abad et al.; licensee BioMed Central Ltd. 2013. This article is published under license to BioMed Central Ltd. This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/2.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.