چکیده (انگلیسی):

Background:Acute cough is a common problem in general practice and is often caused by a self-limiting, viral
infection. Nonetheless, antibiotics are often prescribed in this situation, which may lead to unnecessary side effects
and, even worse, the development of antibiotic resistant microorganisms worldwide. This study assessed the role of
point-of-care C-reactive protein (CRP) testing and other predictors of antibiotic prescription in patients who present
with acute cough in general practice.
Methods:Patient characteristics, symptoms, signs, and laboratory and X-ray findings from 348 patients presenting
to 39 general practitioners with acute cough, as well as the GPs themselves, were recorded by fourth-year medical
students during their three-week clerkships in general practice. Patient and clinician characteristics of those
prescribed and not-prescribed antibiotics were compared using a mixed-effects model.
Results:Of 315 patients included in the study, 22% were prescribed antibiotics. The two groups of patients, those
prescribed antibiotics and those treated symptomatically, differed significantly in age, demand for antibiotics, days
of cough, rhinitis, lung auscultation, haemoglobin level, white blood cell count, CRP level and the GP’s license to
self-dispense antibiotics. After regression analysis, only the CRP level, the white blood cell count and the duration of
the symptoms were statistically significant predictors of antibiotic prescription.
Conclusions:The antibiotic prescription rate of 22% in adult patients with acute cough in the Swiss primary care
setting is low compared to other countries. GPs appear to use point-of-care CRP testing in addition to the duration
of clinical symptoms to help them decide whether or not to prescribe antibiotics.