Rationale, Design and Organization of the Delayed Antibiotic Prescription (DAP) Trial: a Randomized Controlled Trial of the Efficacy and Safety of Delayed Antibiotic Prescribing Strategies in the Non-complicated Acute Respiratory Tract Infections In...

Overview

Journal BMC Fam Pract

Publisher Biomed Central

Specialties Health Services
Public Health

Date 2013 May 21

PMID 23682979

Citations 5

Authors

Mariam de la Poza Abad

Gemma Mas Dalmau

Mikel Moreno Bakedano

Ana Isabel Gonzalez GONZALEZ

Yolanda Canellas Criado

Silvia Hernandez Anadon

Rafael Rotaeche Del Campo

Pere Toran Monserrat

Antonio Negrete Palma

Guillem Pera

Eulalia Borrell Thio

Carl Llor

Paul Little

Pablo Alonso Coello

Affiliations

Soon will be listed here.

Abstract

Background: Respiratory tract infections are an important burden in primary care and it's known that they are usually self-limited and that antibiotics only alter its course slightly. This together with the alarming increase of bacterial resistance due to increased use of antimicrobials calls for a need to consider strategies to reduce their use. One of these strategies is the delayed prescription of antibiotics.

Methods: Multicentric, parallel, randomised controlled trial comparing four antibiotic prescribing strategies in acute non-complicated respiratory tract infections. We will include acute pharyngitis, rhinosinusitis, acute bronchitis and acute exacerbation of chronic bronchitis or chronic obstructive pulmonary disease (mild to moderate). The therapeutic strategies compared are: immediate antibiotic treatment, no antibiotic treatment, and two delayed antibiotic prescribing (DAP) strategies with structured advice to use a course of antibiotics in case of worsening of symptoms or not improving (prescription given to patient or prescription left at the reception of the primary care centre 3 days after the first medical visit).

Discussion: Delayed antibiotic prescription has been widely used in Anglo-Saxon countries, however, in Southern Europe there has been little research about this topic. The DAP trial wil evaluate two different delayed strategies in Spain for the main respiratory infections in primary care.

Trial Registration: This trial is registered with ClinicalTrials.gov, number http://NCT01363531.

Citing Articles

Immediate versus delayed versus no antibiotics for respiratory infections.

Spurling G, Dooley L, Clark J, Askew D Cochrane Database Syst Rev. 2023; 10:CD004417.

PMID: 37791590 PMC: 10548498. DOI: 10.1002/14651858.CD004417.pub6.

Effectiveness of antitussives, anticholinergics or honey versus usual care in adults with uncomplicated acute bronchitis: a study protocol of an open randomised clinical trial in primary care.

Cots J, Moragas A, Garcia-Sangenis A, Morros R, Gomez-Lumbreras A, Ouchi D BMJ Open. 2019; 9(5):e028159.

PMID: 31101700 PMC: 6530348. DOI: 10.1136/bmjopen-2018-028159.

Use of delayed antibiotic prescription in primary care: a cross-sectional study.

de la Poza Abad M, Mas Dalmau G, Gich Saladich I, Martinez Garcia L, Llor C, Alonso-Coello P BMC Fam Pract. 2019; 20(1):45.

PMID: 30914044 PMC: 6434640. DOI: 10.1186/s12875-019-0934-7.

How to avoid the inappropriate use of antibiotics in upper respiratory tract infections? A position statement from an expert panel.

Piltcher O, Kosugi E, Sakano E, Mion O, Testa J, Romano F Braz J Otorhinolaryngol. 2018; 84(3):265-279.

PMID: 29588108 PMC: 9449220. DOI: 10.1016/j.bjorl.2018.02.001.

Delayed antibiotic prescriptions for respiratory infections.

Spurling G, Del Mar C, Dooley L, Foxlee R, Farley R Cochrane Database Syst Rev. 2017; 9:CD004417.

PMID: 28881007 PMC: 6372405. DOI: 10.1002/14651858.CD004417.pub5.

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