Appropriateness of urine culture requests in primary care in Spain: A cross-sectional descriptive study.

Objective: Studies evaluating urine culture requests in our country have highlighted a high rate of requests that fall outside the indications specified in clinical guidelines. We evaluated the current degree of inadequacy in the request of urine cultures and how this influences the therapeutic decisions of general practitioners.

Design: Cross-sectional descriptive study.

Duration of severe and moderate symptoms in pharyngitis by cause.

Objective: This study aimed to assess the cause of acute pharyngitis and determine the duration of severe and moderate symptoms based on the aetiology.

Design: Prospective observational study. SITE: One urban health care centre.

Effects of C-reactive protein rapid testing and communication skills training on antibiotic prescribing for acute cough. A cluster factorial randomised controlled trial.

This cluster randomised clinical trial carried out in 20 primary care centres in Barcelona was aimed at assessing the effect of a continuous intervention focused on C-reactive protein (CRP) rapid testing and training in enhanced communication skills (ECS) on antibiotic consumption for adults with acute cough due to lower respiratory tract infection (LRTI). The interventions consisted of general practitioners and nurses' use of CRP point-of-care and training in ECS separately and combined, and usual care. The primary outcomes were antibiotic consumption and variation of the quality-adjusted life years during a 6-week follow-up.

New paradigms on antibiotic recommendations for community-acquired infections in Spain.

Over the last years, the susceptibility activity of the most common microorganisms causing community-acquired infections has significantly changed in Spain. Based on the susceptibility rates of Streptococcus pyogenes, Streptococcus pneumoniae, Haemophilus influenzae, Escherichia coli, and Klebsiella pneumoniae collected from outpatients aged 15 or older with symptoms of respiratory or urinary tract infections in several Microbiology Departments in Catalonia in 2021, penicillin V should be first choice for most respiratory tract infections, amoxicillin and clavulanate for chronic obstructive pulmonary disease exacerbations and a single dose of fosfomycin or a short-course nitrofurantoin should remain first-line treatments for uncomplicated urinary tract infections. Updated information on antimicrobial resistance for general practitioners is crucial for achieving appropriate empirical management of the most common infections by promoting more rational antibiotic use.

Do external urine collection devices reduce contamination in urine samples for women with symptoms of urinary tract infection? A systematic review.

Introduction: To evaluate the impact of external urine collection devices (UCD) on contamination of urine samples in women with symptoms of urinary tract infection.

Methods: This review was conducted according to the Systematic Reviews of Diagnostic Test Accuracy guidelines (PROSPERO CRD42021241758). PubMed was searched for paired sample studies and controlled trials.

Antibiotic deprescribing: Spanish general practitioners' views on a new strategy to reduce inappropriate use of antibiotics in primary care.

Background: A doctor may recommend that a patient stop an antibiotic course before its scheduled completion time if further treatment may cause more harm than benefit.

Objectives: This study explores general practitioners' (GP) opinions about the use of antibiotic deprescribing (AD) in general practice.

Methods: A cross-sectional, questionnaire-based study answered from February to March 2022.

Effectiveness of antitussives, anticholinergics, and honey versus usual care in adults with uncomplicated acute bronchitis: a multiarm randomized clinical trial.

Background: Despite the frequent use of symptomatic therapies in cough, evidence of their benefits is lacking.

Objective: We compared the effectiveness of 3 symptomatic therapies and usual care in acute bronchitis.

Methods: Multicenter, pragmatic, multiarm parallel group, open randomized trial in primary care (ClinicalTrials.

Best methods for urine sample collection for diagnostic accuracy in women with urinary tract infection symptoms: a systematic review.

Background: Most guidelines recommend a midstream urine (MSU) or a midstream clean-catch (MSCC) sample for urinalysis. However, whether this sample is better than others is still controversial.

Objectives: To assess the most adequate non-invasive method to collect a urine specimen for diagnosing urinary tract infections (UTI) in symptomatic non-pregnant women.

Are short courses of antibiotic therapy as effective as standard courses for COPD exacerbations? A systematic review and meta-analysis.

Background: The best duration of antibiotic treatment for chronic obstructive pulmonary disease (COPD) exacerbations is uncertain.

Objective: To evaluate whether a short course of antibiotic therapy is as effective as the standard longer treatment for exacerbations of patients with COPD.

Methods: We searched Pubmed/MEDLINE and trials in relevant systematic reviews from the inception up to March 2021, with no language restrictions.

Efficacy and safety of discontinuing antibiotic treatment for uncomplicated respiratory tract infections when deemed unnecessary. A multicentre, randomized clinical trial in primary care.

Objectives: To determine the benefits and harms of discontinuing unnecessary antibiotic therapy for uncomplicated respiratory tract infections (RTI) when antibiotics are considered no longer necessary.

Methods: Multicentre, open-label, randomized controlled clinical trial in primary care centres from 2017 to 2020 (ClinicalTrials.gov, NCT02900820).

Long Covid-19: Proposed Primary Care Clinical Guidelines for Diagnosis and Disease Management.

Long COVID-19 may be defined as patients who, four weeks after the diagnosis of SARS-Cov-2 infection, continue to have signs and symptoms not explainable by other causes. The estimated frequency is around 10% and signs and symptoms may last for months. The main long-term manifestations observed in other coronaviruses (Severe Acute Respiratory Syndrome (SARS), Middle East respiratory syndrome (MERS)) are very similar to and have clear clinical parallels with SARS-CoV-2: mainly respiratory, musculoskeletal, and neuropsychiatric.

A Co-Design Process to Elaborate Educational Materials to Promote Appropriate Use of Antibiotics for Acute Lower Respiratory Tract Infections in Primary Healthcare in Catalonia (Spain).

Purpose: Co-design processes with patients allow developing health education materials, that are adapted to the population's knowledge and use of language, to reduce inappropriate antibiotic use.

Patients And Methods: This study presents a co-design process of educational material with patients (over 18 years old) with a previous diagnosis of acute lower respiratory tract infection. The co-design was framed within a qualitative study (Phase I, interviews; Phase II, focus group) conducted in Barcelona between April and September 2019.

Autonomy, power dynamics and antibiotic use in primary healthcare: A qualitative study.

Antibiotic resistance is a global health concern. Although numerous strategies have tried to reduce inadequate antibiotic prescribing, antibiotics are still prescribed in 60% of acute lower respiratory tract infections (ALRTIs) cases in Catalonia (Spain). This study aims to explore service users' experiences of ALRTIs, the quality and access to healthcare services, and health education.

Long-term impact of an intervention on rapid antigen detection tests in acute pharyngitis.

Objective: This study was aimed at evaluating the appropriateness of use and interpretation of rapid antigen detection testing (RADT) and antibiotic prescribing for acute pharyngitis six years after a multifaceted intervention.

Design: Before-and-after audit-based study.

Location: Primary care centres in eight autonomous Communities.

Effectiveness and cost-effectiveness of Improving clinicians' diagnostic and communication Skills on Antibiotic prescribing Appropriateness in patients with acute Cough in primary care in CATalonia (the ISAAC-CAT study): study protocol for a cluster randomised controlled trial.

Background: Despite their marginal benefit, about 60% of acute lower respiratory tract infections (ALRTIs) are currently treated with antibiotics in Catalonia. This study aims to evaluate the effectiveness and efficiency of a continuous disease-focused intervention (C-reactive protein [CRP]) and an illness-focused intervention (enhancement of communication skills to optimise doctor-patient consultations) on antibiotic prescribing in patients with ALRTIs in Catalan primary care centres.

Methods/design: A cluster randomised, factorial, controlled trial aimed at including 20 primary care centres (N = 2940 patients) with patients older than 18 years of age presenting for a first consultation with an ALRTI will be included in the study.

Use of point-of-care tests and antibiotic prescribing in sore throat and lower respiratory infections by general practitioners.

Introduction: This study was aimed at assessing general practitioners' (GP) reliance on patient history, examination findings and the influence of the utilisation of point-of-care tests (POCT) in antibiotic prescribing for sore throat and lower respiratory tract infections (LRTI).

Methods: Audit-based study carried out in 2015. A group of GPs received an intervention six years earlier with provision of POCTs and another group of GPs acted as controls.

Long-term effect of a practice-based intervention (HAPPY AUDIT) aimed at reducing antibiotic prescribing in patients with respiratory tract infections.

Objectives: Few studies have evaluated the long-term effects of educational interventions on antibiotic prescription and the results are controversial. This study was aimed at assessing the effect of a multifaceted practice-based intervention carried out 6 years earlier on current antibiotic prescription for respiratory tract infections (RTIs).

Methods: The 210 general practitioners (GPs) who completed the first two registrations in 2008 and 2009 were invited to participate in a third registration.