title: Estimated saving of antibiotics in pharyngitis and lower respiratory tract infections if general practitioners used rapid tests and followed guidelines.
abstract: BACKGROUND
  General practitioners (GP) in Spain do not have access to rapid tests and adherence to guidelines is usually suboptimal. The aim of the study is to evaluate the estimated number of antibiotics that could have been saved if GPs had appropriately used these tests and had followed the guidelines.
  
  
  METHODS
  Observational study.
  
  
  METHODS
  Primary care centres from eight Autonomous Communities in Spain.
  
  
  METHODS
  GPs who had not participated in previous studies on rational use of antibiotics.
  
  
  METHODS
  GPs registered all the cases of pharyngitis and lower respiratory tract infections (LRTI) during 15 working days in 2015, by means of a 47-item audit.
  
  
  METHODS
  Actual GPs' antibiotic prescription and estimated number of antibiotics that could have been saved according to recent guidelines.
  
  
  RESULTS
  A total of 126 GPs registered 1012 episodes of pharyngitis and 1928 LRTIs. Antibiotics were given or patients were referred in 497 patients with pharyngitis (49.1%) and 963 patients with LRTI (49.9%). If GPs had appropriately used rapid antigen detection tests and C-reactive protein tests and had strictly followed current guidelines, antibiotics would have been given to 7.6% and 15.1%, respectively, with an estimated saving of 420 antibiotics in patients with sore throat (estimated saving of 84.5%; 95% CI: 81.1-87.4%) and 672 antibiotics in LRTIs (estimated saving of 69.8%,95% CI: 67.1-72.5%).
  
  
  CONCLUSIONS
  GP adherence to guidelines and a correct introduction of rapid tests in clinical practice in Spain could result in a considerable saving of unnecessary prescription of antibiotics in pharyngitis and LRTIs.
authors.affiliation: Primary Care Centre Via Roma, Barcelona, Spain. Electronic address: carles.llor@gmail.com.
authors.forename: Carles
authors.initials: C
authors.lastname: Llor
authors.affiliation: University Rovira i Virgili, Primary Care Centre Jaume I, Tarragona, Spain.
authors.forename: Ana
authors.initials: A
authors.lastname: Moragas
authors.affiliation: University of Barcelona, Coordinator of the GdT Enfermedades Infecciosas, Sociedad Española de Medicina de Familia y Comunitaria (semFYC), Primary Care Centre La Marina, Barcelona, Spain.
authors.forename: Josep M
authors.initials: JM
authors.lastname: Cots
authors.affiliation: Economist Department of Quantitative Methods for Economics and Management, University of Las Palmas, Las Palmas de Gran Canaria, Spain.
authors.forename: Beatriz González
authors.initials: BG
authors.lastname: López-Valcárcel
mesh_terms: D000328:Adult; D000900:Anti-Bacterial Agents / Q000627:therapeutic use*; D003663:Decision Trees; D003955:Diagnostic Tests, Routine; D004363:Drug Utilization / Q000706:statistics & numerical data*; D005260:Female; D058006:General Practice / Q000592:standards*; D019983:Guideline Adherence; D006801:Humans; D008297:Male; D008875:Middle Aged; D010612:Pharyngitis / Q000175:diagnosis / Q000188:drug therapy*; D012141:Respiratory Tract Infections / Q000175:diagnosis / Q000188:drug therapy*; D013030:Spain; D013997:Time Factors
chemical_list: D000900:Anti-Bacterial Agents
keywords: Antibiotics; Antibióticos; Audit; Auditoría; Infección respiratoria; Point-of-care test; Prueba de diagnóstico rápido; Respiratory tract infections