The effects of antibiotic prescribing for respiratory tract infection on future consultations in primary care: a systematic review and meta-analysis
Abstract
Abstract Objectives Prescribing antibiotics may reinforce patients' beliefs antibiotics are needed and increase future consultations for similar symptoms. This review determines the effect of antibiotic prescribing for respiratory infections in primary care on future reattendance. Design, setting and participants A systematic review and meta-analysis of randomised controlled trials and cohort studies, following Preferred Reporting Items for Systematic Reviews and Meta-Analysis (PRISMA) guidelines. Participants were adults or children presenting with respiratory infection in primary care. Interventions Prescription of antibiotics. Primary outcome measure Reattendance at least 28 days after initial consultation. Method Eligible studies included open-label randomised controlled trials (RCT) or cohort studies of antibiotics compared to no antibiotics in adults or children with respiratory infections. MEDLINE (Ovid), PubMed, Embase, the Cochrane Central Register of Controlled Trials, clinical trial registries and grey literature sources were searched from inception until 6th February 2024. Two reviewers independently screened, selected, assessed quality and extracted data. Separate meta-analyses were presented for RCT and cohort studies. Results We identified 2128 records and reviewed 48 full texts, of which five met inclusion criteria. These reported three RCTs (1207 randomised to antibiotics, 672 controls) and three cohort studies (209,138 exposed to antibiotics, 46,469…
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