The British journal of general practice : the journal of the Royal College of General Practitioners
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Comment Review
Do delayed prescriptions reduce antibiotic use in respiratory tract infections? A systematic review.
There is concern about the increasing resistance of antibiotics to common bacteria. Delayed prescribing for respiratory tract infections is a strategy that may reduce the use of antibiotics. ⋯ The consistent reduction in antibiotic usage in the five controlled trials included in this review suggests that delayed prescription is an effective means of reducing antibiotic usage for acute respiratory infections. The duration of delay for prescriptions ranged widely, from 1 to 7 days.
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Innovations are proliferating at the primary-secondary care interface, affecting referral to secondary care and resource use. Evidence about the range of effects and implications for the healthcare system of different types of innovation have not previously been summarised. ⋯ The studies identified were extremely diverse in methodology, clinical subject, organisational form, and quality of evidence. The number of good quality evaluations of innovative schemes to enhance the existing capacity of primary care was small, but increasing. Well-evaluated service initiatives in this area should be supported. Organisational innovations in the structure of service provision need not increase total costs to the National Health Service (NHS), even though costs associated with referral may increase. This review provides limited, partial, and conditional support for current primary care-oriented NHS policy developments in the United Kingdom.