{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,6,5]],"date-time":"2026-06-05T03:07:26Z","timestamp":1780628846501,"version":"3.54.1"},"reference-count":19,"publisher":"Public Library of Science (PLoS)","issue":"12","license":[{"start":{"date-parts":[[2024,12,26]],"date-time":"2024-12-26T00:00:00Z","timestamp":1735171200000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["www.plosone.org"],"crossmark-restriction":false},"short-container-title":["PLoS ONE"],"abstract":"<jats:p>Antibiotic resistance poses a significant human and economic burden. In France, which ranks among the highest consumers of antibiotics in Europe, 93% of prescriptions are issued in primary care, primarily for respiratory tract infections. It is crucial to limit both the indications and the duration of antibiotic prescriptions, with recently updated recommendations in France aimed at achieving this goal. Our main objective was to evaluate whether general practitioners\u2019 antibiotic initiation and prescription durations for respiratory infections align with these recommendations. In this prospective cross-sectional study conducted over six weeks in two multi-professional health centers, all consultations for respiratory infections (in both adults and children) documented in patients\u2019 medical records were reviewed. Overall, 46.8% (N = 334\/714) of consultations resulted in an antibiotic prescription (15.8% for nasopharyngitis and 83.5% for acute cough and bronchitis). Compliance with recommended antibiotic durations was observed in 66.7% (N = 476\/714) [95% CI: 63.1%-70.0%] of consultations, with adherence rates exceeding 80% for nasopharyngitis and pharyngitis but falling below 20% for community-acquired pneumonia and acute cough and bronchitis. In total, 1,194 excess days of antibiotic therapy were identified, with an average excess of 1.7 days per prescription [95% CI: 1.4\u20131.9]. There remains significant room for improvement in both reducing the initiation of antibiotic treatments and shortening their prescribed durations. Managing acute coughs and bronchitis continues to be one of the key challenges in primary care. For nasopharyngitis, the high frequency of this condition translates into potentially large prescribing volumes on a collective scale. Efforts to promote the new paradigm of \"shorter is better\" for antibiotic prescription durations need to be intensified.<\/jats:p>","DOI":"10.1371\/journal.pone.0315128","type":"journal-article","created":{"date-parts":[[2024,12,26]],"date-time":"2024-12-26T18:28:44Z","timestamp":1735237724000},"page":"e0315128","update-policy":"https:\/\/doi.org\/10.1371\/journal.pone.corrections_policy","source":"Crossref","is-referenced-by-count":3,"title":["Evaluation of antibiotic treatment initiation and duration practices in primary care. Cross-sectional study in two French multi-professional health centers"],"prefix":"10.1371","volume":"19","author":[{"given":"Simon","family":"Ferme","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Emmanuel","family":"Piednoir","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Marianne","family":"Delestre","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Elise","family":"Fiaux","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Johann","family":"Masik","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Renaud","family":"Verdon","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-4342-4391","authenticated-orcid":true,"given":"Pascal","family":"Thibon","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"340","published-online":{"date-parts":[[2024,12,26]]},"reference":[{"key":"pone.0315128.ref001","unstructured":"World Health Organization. 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Muller","year":"2006","journal-title":"J Antimicrob Chemother"},{"issue":"9","key":"pone.0315128.ref006","doi-asserted-by":"crossref","first-page":"1308","DOI":"10.1001\/jamainternmed.2017.1938","article-title":"Association of Adverse Events With Antibiotic Use in Hospitalized Patients","volume":"177","author":"PD Tamma","year":"2017","journal-title":"JAMA Intern Med. sept"},{"key":"pone.0315128.ref007","unstructured":"Commissioner O of the. FDA updates warnings for fluoroquinolone antibiotics on risks of mental health and low blood sugar adverse reactions [Internet]. FDA. FDA; 2020. https:\/\/www.fda.gov\/news-events\/press-announcements\/fda-updates-warnings-fluoroquinolone-antibiotics-risks-mental-health-and-low-blood-sugar-adverse"},{"key":"pone.0315128.ref008","unstructured":"European Centre for Disease Prevention and Control. Antimicrobial consumption in the EU\/EEA (ESAC-Net)\u2014Annual Epidemiological Report 2021. Stockholm: ECDC; 2022."},{"key":"pone.0315128.ref009","doi-asserted-by":"crossref","unstructured":"Cavali\u00e9 P, Ben Hmidene G, Maugat S, Berger-Carbonne A. Consommation d\u2019antibiotiques en secteur de ville en France, 2011\u20132021. Saint-Maurice: Sant\u00e9 publique France, 2022. 19 p. www.santepubliquefrance.fr","DOI":"10.1016\/j.mmifmc.2022.03.093"},{"issue":"11","key":"pone.0315128.ref010","first-page":"CD010130","article-title":"Biomarkers as point-of-care tests to guide prescription of antibiotics in patients with acute respiratory infections in primary care","author":"R Aabenhus","year":"2014","journal-title":"Cochrane Database Syst Rev"},{"issue":"2","key":"pone.0315128.ref011","doi-asserted-by":"crossref","first-page":"114","DOI":"10.1016\/j.idnow.2020.12.001","article-title":"Anti-infectious treatment duration: The SPILF and GPIP French guidelines and recommendations","volume":"51","author":"R Gauzit","year":"2021","journal-title":"Infect Dis Now"},{"issue":"10","key":"pone.0315128.ref012","doi-asserted-by":"crossref","first-page":"e663","DOI":"10.1093\/cid\/ciaa1404","article-title":"Duration of Outpatient Antibiotic Therapy for Common Outpatient Infections, 2017","volume":"72","author":"LM King","year":"2021","journal-title":"Clin Infect Dis"},{"issue":"7","key":"pone.0315128.ref013","doi-asserted-by":"crossref","first-page":"992","DOI":"10.1001\/jamainternmed.2018.0407","article-title":"Antibiotic Therapy Duration in US Adults With Sinusitis","volume":"178","author":"LM King","year":"2018","journal-title":"JAMA Intern Med"},{"issue":"4","key":"pone.0315128.ref014","doi-asserted-by":"crossref","first-page":"455","DOI":"10.1093\/fampra\/cmx118","article-title":"Informing antimicrobial stewardship: factors associated with inappropriate antimicrobial prescribing in primary care","volume":"35","author":"A Singer","year":"2018","journal-title":"Fam Pract"},{"key":"pone.0315128.ref015","doi-asserted-by":"crossref","first-page":"l440","DOI":"10.1136\/bmj.l440","article-title":"Duration of antibiotic treatment for common infections in English primary care: cross sectional analysis and comparison with guidelines","volume":"364","author":"KB Pouwels","year":"2019","journal-title":"BMJ"},{"issue":"17","key":"pone.0315128.ref016","doi-asserted-by":"crossref","first-page":"1440","DOI":"10.1001\/jama.1997.03550170070035","article-title":"Does this patient have community-acquired pneumonia? Diagnosing pneumonia by history and physical examination","volume":"278","author":"JP Metlay","year":"1997","journal-title":"JAMA"},{"key":"pone.0315128.ref017","unstructured":"Public Health England. National Institute for Health and Care Excellence. Summary of antimicrobial prescribing guidance\u2013managing common infections. https:\/\/www.bnf.org\/news\/2021\/07\/29\/bnf-hosts-antimicrobial-summary-guidance-on-behalf-of-nice-and-phe\/. Assessed 2023\/03\/23."},{"issue":"5","key":"pone.0315128.ref018","doi-asserted-by":"crossref","first-page":"1256","DOI":"10.1016\/j.chest.2020.01.044","article-title":"Acute Cough Due to Acute Bronchitis in Immunocompetent Adult Outpatients: CHEST Expert Panel Report","volume":"157","author":"MP Smith","year":"2020","journal-title":"Chest"},{"issue":"9","key":"pone.0315128.ref019","doi-asserted-by":"crossref","first-page":"1254","DOI":"10.1001\/jamainternmed.2016.3646","article-title":"The New Antibiotic Mantra-\"Shorter Is Better\"","volume":"176","author":"B. 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