Reattendance and complications in a randomised trial of prescribing strategies for sore throat : the medicalising effect of prescribing antibiotics.
To assess the medicalising effect of prescribing antibiotics for sore throat Setting : 11 general practices in England.
Randomised trial of three approaches to sore throat : a 10 day prescription of antibiotics, no antibiotics, or a delayed prescription if the sore throat had not started to settle after three days.
716 patients aged 4 and over with sore throat and an abnormal physical sign : 84% had tonsillitis or pharyngitis.
Number and rate of patients making a first return with sore throat pharyngitis, or tonsillitis.
Early returns (within two weeks) and complications (otitis media, sinusitis, quinsy).
Outcomes were documented in 675 subjects (94%)
Results : Mean follow up time was similar (antibiotic group 1.07 years, other two groups 1.03 years).
More of those initially prescribed antibiotics initially returned to the surgery with sore throat (38% v 27%, adjusted hazard ratio for return 1.39,95% confidence interval 1.03 to 1.89).
Antibiotics prescribed for sore throat during the previous year had an additional effect (hazard ratio 1.69,1.20 to 2.37).
Longer duration of illness (>5 days) was associated with increased return within six weeks (hazard ratio 2.90,1.70 to 4.92).
Prior attendance with upper respiratory conditions was also associated with increased reattendance.
There was no difference between groups in early return (13/238 (5.5%) v 27/437 (6%)), or complications (2/236 (0.8%) v 3/434 (0.7%)). (...)
Mots-clés Pascal : Angine, Antibiotique, Chimiothérapie, Qualité, Soin, Pratique professionnelle, Angleterre, Grande Bretagne, Royaume Uni, Europe, Traitement, Evaluation, Homme, ORL pathologie, Pharynx pathologie
Mots-clés Pascal anglais : Angina, Antibiotic, Chemotherapy, Quality, Care, Professional practice, England, Great Britain, United Kingdom, Europe, Treatment, Evaluation, Human, ENT disease, Pharynx disease
Notice produite par :
Inist-CNRS - Institut de l'Information Scientifique et Technique
Cote : 97-0437364
Code Inist : 002B02E. Création : 19/12/1997.