Effects of Delayed Antibiotic Prescribing vs. Immediate or No Antibiotic for URI's in Primary Care: A Systematic Review [paper]
Duong, Lanh T.
Introduction: Delayed antibiotic prescription (DAP) is an evidence-based intervention to fight the global issue of antibiotic resistance. Evidence of its benefits for treating respiratory tract infections (RTIs) have long existed in literature but never fully accepted. This paper’s purpose is to evaluate new evidence and the overall effects of DAP on patients with upper respiratory infections in the primary care practice. Methods: This systematic review of the literature was guided by the PARIHS model to investigate patient outcomes and satisfaction rates with delayed antibiotic prescription compared to immediate and no prescription when treating RTI symptoms. JSTOR Journals, Health Source, OVID, CINAHL, Cochrane, PubMed, and MEDLINE were databases used in gathering the literature. Articles were screened with an inclusion criterion. A Rapid Critical Appraisal Tool was used to score articles on its relevance and validity to answer the PICOT question. Articles’ quality appraisal score of less than four were excluded from this review. Scores are illustrated in the Evidence Synthesis Table. Results: Five randomized controlled trials and three cohort studies were analyzed. Study findings overall revealed that DAP reduces antibiotic use, and no significant difference was seen in symptom severity through all prescribing approaches. Interestingly, only two of the three studies found that DAP is related to higher patient satisfaction. Discussion: DAP can be used safely in most patients with acute RTIs. However, more research is needed in the United States to give a better generalizability to the population.
delayed antibiotic prescribing, no antibiotics, upper respiratory infections, treatment, primary care, patient satisfaction, Nursing
Duong, L. T. (2022). Effects of delayed antibiotic prescribing vs. immediate or no antibiotic for URI's in primary care: A systematic review [Report]. St. David's School of Nursing, Texas State University.