PT  - JOURNAL ARTICLE
AU  - Nick A Francis
AU  - David Gillespie
AU  - Jacqueline Nuttall
AU  - Kerenza Hood
AU  - Paul Little
AU  - Theo Verheij
AU  - Samuel Coenen
AU  - Jochen W Cals
AU  - Herman Goossens
AU  - Christopher C Butler
TI  - Antibiotics for acute cough: an international observational study of patient adherence in primary care
AID  - 10.3399/bjgp12X649124
DP  - 2012 Jun 01
TA  - British Journal of General Practice
PG  - e429--e437
VI  - 62
IP  - 599
4099  - http://bjgp.org/content/62/599/e429.short
4100  - http://bjgp.org/content/62/599/e429.full
SO  - Br J Gen Pract2012 Jun 01; 62
AB  - Background Non-adherence to acute antibiotic prescriptions is poorly described and may impact on clinical outcomes, healthcare costs, and interpretation of research. It also results in leftover antibiotics that could be used inappropriately.Aim To describe adherence to antibiotics prescribed for adults presenting with acute cough in primary care, factors associated with non-adherence, and associated recovery.Design and setting Prospective observational cohort study in general practices in 14 European primary care networks.Method GPs recorded patient characteristics and prescribing decisions for adults with acute cough or clinical presentation suggestive of lower respiratory tract infection. Patients recorded antibiotic consumption and daily symptoms over 28 days. Rates of adherence to prescribed antibiotics were assessed, and factors associated with non-adherence were identified using logistic regression. Recovery was compared using a Cox proportional hazards model.Results Of 2520 patients prescribed immediate or no antibiotics at the index consultation, 282 (11.2%) took an antibiotic during the follow-up period that was not prescribed for them at the index consultation. Of these, 38.1% had no reconsultations during this period. Prior duration of symptoms, antibiotic treatment duration, antibiotic choice, and primary care network were all associated with adherence. There was no difference in time to recovery between those who were prescribed antibiotics at the index consultation and were fully adherent, partially adherent, and non-adherent.Conclusion Non-adherence to antibiotics for acute cough or lower respiratory tract infection is common. Duration of treatment, choice of antibiotic, and setting were associated with adherence but adherence to treatment was not associated with differences in recovery.