{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,16]],"date-time":"2026-10-16T22:05:52Z","timestamp":1792188352003,"version":"4.4.0"},"reference-count":24,"publisher":"Royal College of General Practitioners","issue":"2","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["BJGP Open"],"accepted":{"date-parts":[[2024,11,4]]},"published-print":{"date-parts":[[2025,7]]},"abstract":"<jats:sec>\n                  <jats:title>Background<\/jats:title>\n                  <jats:p>Illness severity, comorbidity, fever, age, and symptom duration influence antibiotic prescribing for respiratory tract infections (RTI). Non-medical determinants, such as patient expectations, also impact prescribing.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Aim<\/jats:title>\n                  <jats:p>To quantify the effect of a GP\u2019s perception of a patient request for antibiotics on antibiotic prescribing for RTI and investigate effect modification by medical determinants and country.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Design &amp; setting<\/jats:title>\n                  <jats:p>Prospective audit of general practices in 18 European countries.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Method<\/jats:title>\n                  <jats:p>Consultation data were registered of 4982 patients presenting with acute cough and\/or sore throat. A mixed-effect logistic regression model analysed the effect of GPs\u2019 perceptions of a patient request for antibiotics. Two-way interaction terms assessed effect modification. Relevant clinical findings were added to subgroups of lower RTI (LRTI), throat infection, and influenza-like-illness (ILI).<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Results<\/jats:title>\n                  <jats:p>A GP\u2019s perception of a request for antibiotics meant they were four times more likely to prescribe antibiotics (odds ratio [OR] 4.4, 95% confidence interval [CI] = 3.4 to 5.5). This effect varied by country: lower in Spain (OR 0.06), Ukraine (OR 0.15), and Greece (OR 0.22) compared with the lowest prescribing country. The effect was higher for ILI (OR 13.86, 95% CI = 5.5 to 35) and throat infection (OR 5.1, 95% CI = 3.1 to 8.4) than for LRTI (OR 2.9, 95% CI = 1.9 to 4.3). For ILI and LRTI, GPs were more likely to prescribe antibiotics with abnormal lung auscultation and\/or increased or purulent sputum and for throat infection, with tonsillar exudate and\/or swollen tonsils.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Conclusion<\/jats:title>\n                  <jats:p>GPs\u2019 perceptions of an antibiotic request and specific clinical findings influence antibiotic prescribing. Incorporating exploration of patient expectations, point-of-care testing, and discussing watchful waiting into the decision-making process will benefit appropriate prescribing of antibiotics.<\/jats:p>\n               <\/jats:sec>","DOI":"10.3399\/bjgpo.2024.0166","type":"journal-article","created":{"date-parts":[[2025,1,17]],"date-time":"2025-01-17T05:25:11Z","timestamp":1737091511000},"page":"BJGPO.2024.0166","source":"Crossref","is-referenced-by-count":10,"title":["The effect of a GP\u2019s perception of a patient request for antibiotics on antibiotic prescribing for respiratory tract infections: secondary analysis of a point-prevalence audit survey in 18 European 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