{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,6,16]],"date-time":"2026-06-16T22:31:05Z","timestamp":1781649065997,"version":"3.54.5"},"reference-count":11,"publisher":"Oxford University Press (OUP)","issue":"2","license":[{"start":{"date-parts":[[2023,12,15]],"date-time":"2023-12-15T00:00:00Z","timestamp":1702598400000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/academic.oup.com\/pages\/standard-publication-reuse-rights"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2024,2,1]]},"abstract":"<jats:title>Abstract<\/jats:title>\n               <jats:sec>\n                  <jats:title>Background<\/jats:title>\n                  <jats:p>In patients without ethnicity risk factors for acute rheumatic fever (ARF), our local guidelines recommend limiting antibiotic use following a positive throat swab culture (TSC). If symptoms are severe, a 5\u20137 day course is recommended. Despite this, most local patients with a positive TSC for group A Streptococcus (GAS) or Streptococcus dysgalactiae subsp. equisimilis (SDSE) were being prescribed 10 days of antibiotics. In response, we added comments to positive TSC reports recommending shorter treatment durations in those without ARF risk factors. No other antimicrobial stewardship initiatives were implemented.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Objectives<\/jats:title>\n                  <jats:p>To assess the effect of these comments on antibiotic course duration after positive TSC.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Methods<\/jats:title>\n                  <jats:p>All community TSC results from 1 October 2021 to 31 March 2023 (1 year pre- to 6 months post-change) were matched to antibiotic dispensing data. Patients who had been empirically dispensed an antibiotic prior to the culture report were excluded. The outcome of interest was the antibiotic duration dispensed in the 5 day period after the TSC report.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Results<\/jats:title>\n                  <jats:p>Following introduction of the comments, median course duration reduced from 10 (IQR 5\u201310) to 7 days (IQR 0\u201310; P &amp;lt; 0.01) and from 7 (IQR 0\u201310) to 0 days (IQR 0\u20135; P &amp;lt; 0.01) following GAS- and SDSE-positive TSC, respectively, in those without ARF risk factors. The percentage of people receiving 10 days of antibiotics decreased from 63.0% to 37.0% (P &amp;lt; 0.01) and 41.2% to 14.6% (P &amp;lt; 0.01) for GAS and SDSE, respectively.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Conclusions<\/jats:title>\n                  <jats:p>The introduction of comments providing direct prescribing advice to requestors appears to have been highly effective at improving guideline-compliant prescribing following positive TSC report.<\/jats:p>\n               <\/jats:sec>","DOI":"10.1093\/jac\/dkad384","type":"journal-article","created":{"date-parts":[[2023,12,16]],"date-time":"2023-12-16T02:27:31Z","timestamp":1702693651000},"page":"334-338","source":"Crossref","is-referenced-by-count":2,"title":["Effect of directive laboratory comments on prescribing response to positive throat swab cultures"],"prefix":"10.1093","volume":"79","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-3920-7151","authenticated-orcid":false,"given":"Max","family":"Bloomfield","sequence":"first","affiliation":[{"name":"Department of Microbiology, Wellington Southern Community Laboratories , Wellington , New Zealand"},{"name":"Department of Infection Services, Wellington Regional Hospital , Wellington , New Zealand"},{"name":"Antimicrobial Stewardship Committee, Te Whatu Ora\u2014Capital, Coast and Hutt Valley , Wellington , New Zealand"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Koen","family":"van der Werff","sequence":"additional","affiliation":[{"name":"Department of Microbiology, Wellington Southern Community Laboratories , Wellington , New Zealand"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sue","family":"Todd","sequence":"additional","affiliation":[{"name":"Antimicrobial Stewardship Committee, Te Whatu Ora\u2014Capital, Coast and Hutt Valley , Wellington , New Zealand"},{"name":"Ora Toa Cannons Creek General Practice , Porirua , New Zealand"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Michelle","family":"Balm","sequence":"additional","affiliation":[{"name":"Department of Microbiology, Wellington Southern Community Laboratories , Wellington , New Zealand"},{"name":"Department of Infection Services, Wellington Regional Hospital , Wellington , New Zealand"},{"name":"Antimicrobial Stewardship Committee, Te Whatu Ora\u2014Capital, Coast and Hutt Valley , Wellington , New Zealand"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Tim","family":"Blackmore","sequence":"additional","affiliation":[{"name":"Department of Microbiology, Wellington Southern Community Laboratories , Wellington , New Zealand"},{"name":"Department of Infection Services, Wellington Regional Hospital , Wellington , New Zealand"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"286","published-online":{"date-parts":[[2023,12,15]]},"reference":[{"key":"2024020113250662900_dkad384-B1","doi-asserted-by":"crossref","first-page":"e006245","DOI":"10.1136\/bmjopen-2014-006245","article-title":"Continued high rates of antibiotic prescribing to adults with respiratory tract infection: survey of 568 UK general practices","volume":"4","author":"Gulliford","year":"2014","journal-title":"BMJ Open"},{"key":"2024020113250662900_dkad384-B2","doi-asserted-by":"crossref","first-page":"e557","DOI":"10.1542\/peds.2009-2648","article-title":"Prevalence of streptococcal pharyngitis and streptococcal carriage in children: a meta-analysis","volume":"126","author":"Shaikh","year":"2010","journal-title":"Pediatrics"},{"key":"2024020113250662900_dkad384-B3","doi-asserted-by":"crossref","first-page":"179","DOI":"10.1111\/j.1440-1754.2011.02218.x","article-title":"Rheumatic fever in New Zealand","volume":"49","author":"Webb","year":"2013","journal-title":"J Paediatr Child Health"},{"key":"2024020113250662900_dkad384-B4","author":"Te Whatu Ora"},{"key":"2024020113250662900_dkad384-B5","volume-title":"Group A Streptococcal Sore Throat Management - Guideline","author":"National Heart Foundation of New Zealand","year":"2019"},{"key":"2024020113250662900_dkad384-B6","author":"Community HealthPathways"},{"key":"2024020113250662900_dkad384-B7","doi-asserted-by":"crossref","first-page":"268","DOI":"10.1016\/j.jpeds.2018.10.048","article-title":"Beta-hemolytic nongroup A streptococcal pharyngitis in children","volume":"206","author":"Frost","year":"2019","journal-title":"J Pediatr"},{"key":"2024020113250662900_dkad384-B8","doi-asserted-by":"crossref","first-page":"563627","DOI":"10.3389\/fcimb.2020.563627","article-title":"Diagnostic methods, clinical guidelines, and antibiotic treatment for group A streptococcal pharyngitis: a narrative review","volume":"10","author":"Mustafa","year":"2020","journal-title":"Front Cell Infect Microbiol"},{"key":"2024020113250662900_dkad384-B9","doi-asserted-by":"crossref","first-page":"1400","DOI":"10.1017\/ice.2019.293","article-title":"Nudging In MicroBiology Laboratory Evaluation (NIMBLE): a scoping review","volume":"40","author":"Langford","year":"2019","journal-title":"Infect Control Hosp Epidemiol"},{"key":"2024020113250662900_dkad384-B10","doi-asserted-by":"crossref","first-page":"ofac147","DOI":"10.1093\/ofid\/ofac147","article-title":"The impact of point-of-care polymerase chain reaction testing on prescribing practices in primary care for management of strep A: a retrospective before\u2013after study","volume":"9","author":"May","year":"2022","journal-title":"Open Forum Infect Dis"},{"key":"2024020113250662900_dkad384-B11","author":"BPAC NZ"}],"container-title":["Journal of Antimicrobial Chemotherapy"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/academic.oup.com\/jac\/article-pdf\/79\/2\/334\/56418249\/dkad384.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"syndication"},{"URL":"https:\/\/academic.oup.com\/jac\/article-pdf\/79\/2\/334\/56418249\/dkad384.pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2024,2,1]],"date-time":"2024-02-01T13:25:33Z","timestamp":1706793933000},"score":1,"resource":{"primary":{"URL":"https:\/\/academic.oup.com\/jac\/article\/79\/2\/334\/7475064"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2023,12,15]]},"references-count":11,"journal-issue":{"issue":"2","published-online":{"date-parts":[[2023,12,15]]},"published-print":{"date-parts":[[2024,2,1]]}},"URL":"https:\/\/doi.org\/10.1093\/jac\/dkad384","relation":{},"ISSN":["0305-7453","1460-2091"],"issn-type":[{"value":"0305-7453","type":"print"},{"value":"1460-2091","type":"electronic"}],"subject":[],"published-other":{"date-parts":[[2024,2]]},"published":{"date-parts":[[2023,12,15]]}}}