Background: Acute respiratory tract infections (ARTI) are the main cause of inappropriate antibiotic prescribing. To date, there is limited evidence concerning whether low levels of antibiotic prescribing may impact patient safety. We investigate whether antibiotic prescribing for patients seeking primary care for ARTI correlates with the odds for hospitalization. Methods: Analysis of patient baseline data (n = 3669) within a cluster-randomized controlled trial. Adult patients suffering from ARTI in German primary care are included. The main outcome measure is acute hospitalization for respiratory infection and for any acute disease from 0 to 42 days after initial consultation. Results: Neither the antibiotic status of individual patients (OR 0.91; 95% CI: 0.49 to 1.69; p-value = 0.769) nor the physician-specific antibiotic prescription rates for ARTI (OR 1.22; 95% CI: 1.00 to 1.49; p-value = 0.054) had a significant effect on hospitalization. The following factors increased the odds for hospitalization: patient’s age, the ARTI being defined as lower respiratory tract infections (such as bronchitis) by the physician, the physician’s perception of disease severity, and being cared for within group practices (versus treated in single-handed practices). Conclusions: In a low-antibiotic-prescribing primary care setting such as Germany, lack of treatment with antibiotics for ARTI did not result in higher odds for hospitalization in an adult population.

中文翻译：

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在低抗生素处方环境中进行急性呼吸道感染的住院治疗：来自一般实践的跨部门数据

背景：急性呼吸道感染（ARTI）是抗生素处方不当的主要原因。迄今为止，关于低水平的抗生素处方是否会影响患者安全的证据有限。我们调查为寻求ARTI初级治疗的患者开出的抗生素处方是否与住院几率相关。方法：在一项集群随机对照试验中分析患者基线数据（n = 3669）。包括德国初级保健中患有ARTI的成年患者。主要结局指标是在首次咨询后0到42天进行呼吸道感染以及任何急性疾病的急性住院治疗。结果：个别患者的抗生素状况均未（OR 0.91； 95％CI：0.49至1.69；p值= 0.769）或ARTI的医师特定抗生素处方率（OR 1.22; 95％CI：1.00至1.49; p值= 0.054）对住院都有显着影响。以下因素增加了住院的几率：患者的年龄，ARTI被定义为医师下呼吸道感染（例如支气管炎），医师对疾病严重程度的认识以及在小组实践中得到的护理（与单次治疗相比）手法）。结论：在处方药水平低的基层医疗机构（例如德国）中，缺乏针对ARTI的抗生素治疗不会导致成人人群住院的几率更高。