title: 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 general practice.
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).
  
  
  CONCLUSIONS
  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.
  
  
  BACKGROUND
  This trial is registered with ClinicalTrials.gov, number http://NCT01363531.
authors.affiliation: Centro de Atención Primaria Doctor Carles Ribas, Barcelona, Spain.
authors.forename: Mariam
authors.initials: M
authors.lastname: de la Poza Abad
authors.forename: Gemma
authors.initials: G
authors.lastname: Mas Dalmau
authors.forename: Mikel
authors.initials: M
authors.lastname: Moreno Bakedano
authors.forename: Ana Isabel
authors.initials: AI
authors.lastname: González González
authors.forename: Yolanda
authors.initials: Y
authors.lastname: Canellas Criado
authors.forename: Silvia
authors.initials: S
authors.lastname: Hernández Anadón
authors.forename: Rafael
authors.initials: R
authors.lastname: Rotaeche del Campo
authors.forename: Pere
authors.initials: P
authors.lastname: Torán Monserrat
authors.forename: Antonio
authors.initials: A
authors.lastname: Negrete Palma
authors.forename: Guillem
authors.initials: G
authors.lastname: Pera
authors.forename: Eulàlia
authors.initials: E
authors.lastname: Borrell Thió
authors.forename: Carl
authors.initials: C
authors.lastname: Llor
authors.forename: Paul
authors.initials: P
authors.lastname: Little
authors.forename: Pablo
authors.initials: P
authors.lastname: Alonso Coello
mesh_terms: D000208:Acute Disease; D000900:Anti-Bacterial Agents / Q000627:therapeutic use*; D001424:Bacterial Infections / Q000188:drug therapy*; D011307:Drug Prescriptions; D006801:Humans; D010818:Practice Patterns, Physicians'; D011364:Professional Practice; D012107:Research Design; D012141:Respiratory Tract Infections / Q000188:drug therapy*; D013997:Time Factors
chemical_list: D000900:Anti-Bacterial Agents