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Systematic review of determinants influencing antibiotic prescribing for uncomplicated acute respiratory tract infections in adult patients at the emergency department.
Infect Control Hosp Epidemiol. 2020 Oct 29 [Online ahead of print]IC

Abstract

OBJECTIVE

Overuse of antibiotics in the emergency department (ED) for uncomplicated acute respiratory tract infections (uARTIs) is a public health issue that needs to be addressed. We aimed to identify factors associated with antibiotic use for uARTIs in adults presenting at the ED.

DESIGN

We searched Medline, Embase, PsycINFO and the Cochrane Library for articles published from 1 January 2005 to 30 June 2017 using a predetermined search strategy. Titles and abstracts of English articles on antibiotic prescription and inappropriate antibiotic use for adult ARTI at EDs were assessed, followed by full article review, by 2 authors.

SETTING

Emergency departments.

PARTICIPANTS

Adults aged 18 years and older.

RESULTS

Of the 2,591 articles retrieved, 12 articles met the inclusion criteria and 11 studies were conducted in the United States. Patients with normal C-reactive protein levels and positive influenza tests were less likely to receive antibiotic treatment. Nonclinical factors associated with antibiotic use were longer waiting time and perceived patient desire for antibiotics. Patients attended by internal medicine physicians comanaged by house staff or who visited an ED which provided education to healthcare providers on antibiotics use were less likely to receive antibiotics.

CONCLUSIONS

English-language articles that fulfilled the selection criteria outside the United States were limited. Factors associated with antibiotics use are multifaceted. Education of healthcare providers presents an opportunity to improve antibiotic use.

Authors+Show Affiliations

Department of Clinical Epidemiology, Office of Clinical Epidemiology, Analytics, and Knowledge (OCEAN), Tan Tock Seng Hospital, Singapore.Department of Clinical Epidemiology, Office of Clinical Epidemiology, Analytics, and Knowledge (OCEAN), Tan Tock Seng Hospital, Singapore.Department of Clinical Epidemiology, Office of Clinical Epidemiology, Analytics, and Knowledge (OCEAN), Tan Tock Seng Hospital, Singapore.Department of Clinical Epidemiology, Office of Clinical Epidemiology, Analytics, and Knowledge (OCEAN), Tan Tock Seng Hospital, Singapore.Department of Clinical Epidemiology, Office of Clinical Epidemiology, Analytics, and Knowledge (OCEAN), Tan Tock Seng Hospital, Singapore. Lee Kong Chian School of Medicine, Nanyang Technological University, Singapore.

Pub Type(s)

Journal Article

Language

eng

PubMed ID

33118891

Citation

Lim, Dwee Wee, et al. "Systematic Review of Determinants Influencing Antibiotic Prescribing for Uncomplicated Acute Respiratory Tract Infections in Adult Patients at the Emergency Department." Infection Control and Hospital Epidemiology, 2020, pp. 1-10.
Lim DW, Htun HL, Ong LS, et al. Systematic review of determinants influencing antibiotic prescribing for uncomplicated acute respiratory tract infections in adult patients at the emergency department. Infect Control Hosp Epidemiol. 2020.
Lim, D. W., Htun, H. L., Ong, L. S., Guo, H., & Chow, A. (2020). Systematic review of determinants influencing antibiotic prescribing for uncomplicated acute respiratory tract infections in adult patients at the emergency department. Infection Control and Hospital Epidemiology, 1-10. https://doi.org/10.1017/ice.2020.1245
Lim DW, et al. Systematic Review of Determinants Influencing Antibiotic Prescribing for Uncomplicated Acute Respiratory Tract Infections in Adult Patients at the Emergency Department. Infect Control Hosp Epidemiol. 2020 Oct 29;1-10. PubMed PMID: 33118891.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Systematic review of determinants influencing antibiotic prescribing for uncomplicated acute respiratory tract infections in adult patients at the emergency department. AU - Lim,Dwee Wee, AU - Htun,Htet Lin, AU - Ong,Lay See, AU - Guo,Huiling, AU - Chow,Angela, Y1 - 2020/10/29/ PY - 2020/10/29/entrez PY - 2020/10/30/pubmed PY - 2020/10/30/medline SP - 1 EP - 10 JF - Infection control and hospital epidemiology JO - Infect Control Hosp Epidemiol N2 - OBJECTIVE: Overuse of antibiotics in the emergency department (ED) for uncomplicated acute respiratory tract infections (uARTIs) is a public health issue that needs to be addressed. We aimed to identify factors associated with antibiotic use for uARTIs in adults presenting at the ED. DESIGN: We searched Medline, Embase, PsycINFO and the Cochrane Library for articles published from 1 January 2005 to 30 June 2017 using a predetermined search strategy. Titles and abstracts of English articles on antibiotic prescription and inappropriate antibiotic use for adult ARTI at EDs were assessed, followed by full article review, by 2 authors. SETTING: Emergency departments. PARTICIPANTS: Adults aged 18 years and older. RESULTS: Of the 2,591 articles retrieved, 12 articles met the inclusion criteria and 11 studies were conducted in the United States. Patients with normal C-reactive protein levels and positive influenza tests were less likely to receive antibiotic treatment. Nonclinical factors associated with antibiotic use were longer waiting time and perceived patient desire for antibiotics. Patients attended by internal medicine physicians comanaged by house staff or who visited an ED which provided education to healthcare providers on antibiotics use were less likely to receive antibiotics. CONCLUSIONS: English-language articles that fulfilled the selection criteria outside the United States were limited. Factors associated with antibiotics use are multifaceted. Education of healthcare providers presents an opportunity to improve antibiotic use. SN - 1559-6834 UR - https://www.unboundmedicine.com/medline/citation/33118891/Systematic_review_of_determinants_influencing_antibiotic_prescribing_for_uncomplicated_acute_respiratory_tract_infections_in_adult_patients_at_the_emergency_department L2 - https://www.cambridge.org/core/product/identifier/S0899823X20012453/type/journal_article DB - PRIME DP - Unbound Medicine ER -
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