Accuracy of leukocyte esterase and nitrite tests for diagnosing bacteriuria in older adults: A systematic review and meta-analysis.

Background: Urine dipsticks are commonly used for the diagnosis of bacteriuria and/or urinary tract infections (UTIs).

Objectives: To perform a systematic review and meta-analysis to evaluate the accuracy of positive leukocyte esterase and/or nitrite results from dipsticks (index test) for diagnosing bacteriuria in older individuals, using urine culture as the reference standard.

Data Sources: MEDLINE (Pubmed), EMBASE, and Cochrane Database of Systematic Reviews from the inception date up to April 2025.

Exposure to suppressive antibiotic therapy in women with recurrent urinary tract infections and severity of infections: a retrospective population-based cohort study.

Background: Women with recurrent urinary tract infections (UTIs) often undergo intensive antibiotic exposure, especially with suppressive therapies. Suppressive therapy is recommended for women with three UTIs in the past year or two in the last 6 months. However, the collateral long-term effects of this have been poorly studied.

Diagnosing acute lower respiratory tract infections in out-of-hours services during the COVID-19 pandemic.

Background: Acute lower respiratory tract infections (LRTIs) commonly lead people to seek out-of-hours primary care. Symptoms of lower respiratory tract infections overlap, and access to definite diagnostic tools is lacking in most out-of-hours settings. Distinguishing between different LRTIs is vital to ensure appropriate antibiotic prescribing.

Clinicians' perspectives on a primary healthcare intervention to reduce antibiotic prescription for acute lower respiratory tract infections in Barcelona (Spain): a qualitative study.

Background: Interventions based on testing and communication training have been developed to reduce antibiotic prescribing in primary healthcare (PHC) for the treatment of acute lower respiratory infections (ALRTIs). However, research based on the experiences of PHC clinicians participating in ALTRIs interventions to reduce antibiotic prescribing in Barcelona is scanty.

Aim: This study aimed to explore the perceptions and experiences of clinicians (physicians and nurses) on an intervention to reduce antibiotic prescription in PHC in Barcelona (Spain).

C-reactive protein point-of-care testing to guide antibiotic prescribing for respiratory tract infections.

Introduction: Antimicrobial resistance is strongly correlated with the volume of antibiotics used. Most antibiotics are prescribed in primary care, mostly for respiratory tract infections (RTIs), and are often unneeded.

Areas Covered: The current knowledge regarding the use of C-reactive protein (CRP) rapid testing in primary care is outlined.

The impact of a multifaceted intervention on antibiotic use for common infections in nursing homes in Spain. A before and after study.

Purpose: The aim of this study was to assess the impact of a multifaceted intervention aimed at nursing home staff on antibiotic use and hygiene elements for nursing home residents with common infections.

Methods: Before-and-after study carried out in nursing homes in five areas of Spain. Nursing staff registered residents with common infections and documented hygiene practices over three months, before and after a 2-h educational intervention in autumn 2023.

Community pharmacists' role in optimising antibiotic use: The HAPPY PATIENT project to improve dispensing practices in five EU countries.

Background: Community pharmacies can play a pivotal role in optimising the use of antibiotics through their dispensing practice.

Aim: To evaluate the impact of a multifaceted intervention on community pharmacies' quality of antibiotic dispensing.

Method: A prospective before-after study conducted according to the Audit Project Odense methodology in community pharmacies in France, Greece, Lithuania, Poland, and Spain.

Shifting the mindset regarding adherence to antibiotic use for respiratory tract infections.

Some papers emphasize adherence to antibiotic therapy, but a paradigm shift is needed. While nonadherence may impact chronic conditions, it has not been proven to affect community respiratory tract infections outside of tuberculosis. Respiratory infections, which account for most community antibiotic prescriptions, often involve inappropriate antibiotic use, even in developed countries, with up to 80 % of consultations resulting in prescriptions.

Appropriateness of antibiotic use in nursing homes for suspected urinary tract infections: comparison across five European countries.

Purpose: Antibiotic use is the main driver of bacterial antimicrobial resistance. Urinary tract infections (UTIs), for which antibiotics are often prescribed, are among the most common infections among residents in nursing homes. This study aimed to estimate and compare the appropriateness of antibiotic use for suspected UTIs among nursing home residents across five European countries.

Effect of a multifaceted intervention on potentially unnecessary antibiotic prescriptions in general practice, out-of-hours services, and nursing homes in Spain.

Objective: To evaluate the impact of a multifaceted antimicrobial stewardship intervention on potentially unnecessary antibiotic prescribing.

Material And Methods: Before and after quality control study carried out in three different settingsgeneral practice, out-of-hours services, and nursing homesin Spain. Healthcare professionals (both doctors and nurses) self-registered common infections using a specific template for each setting before (2022) and after (2023) receiving a 5-hour intervention on prudent antibiotic use.

Duration of antibiotic treatment for respiratory tract infections in primary care.

Objectives: The primary driver of antimicrobial resistance is excessive antibiotic use, posing a global threat to public health. Reducing individual exposure to antibiotics is a key to addressing the problem. This study aimed to assess the duration of antibiotic courses administered to patients with acute respiratory tract infections (RTIs) in primary care.

Assessment of potentially unnecessary antibiotic use for suspected urinary tract infections in nursing homes using a simplified algorithm.

Background: Nursing home (NH) residents are frequently treated with antibiotics for urinary tract infections (UTIs), often due to overdiagnosis. The aim of this study was to evaluate the proportion of potentially unnecessary antibiotic use for suspected UTIs in NHs across eight European countries.

Research Design And Methods: Over a three-month period (February to April 2024), NH professionals recorded information on all antibiotic treatments for UTIs using a specific registration chart.

Audit and Feedback Interventions for Antibiotic Prescribing in Primary Care: A Systematic Review and Meta-analysis.

Background: This systematic review evaluates the effect of audit and feedback (A&F) interventions targeting antibiotic prescribing in primary care and examines factors that may explain the variation in effectiveness.

Methods: Randomized controlled trials (RCTs) involving A&F interventions targeting antibiotic prescribing in primary care were included in the systematic review. Cochrane Central Register of Controlled Trials, MEDLINE, EMBASE, CINAHL, and ClinicalTrials.

Impact of a multifaceted intervention programme on antibiotic prescribing and dispensing in four patient-centred settings in five European countries. The HAPPY PATIENT project.

Background: The primary cause of antimicrobial resistance is excessive and non-indicated antibiotic use.

Aim: To evaluate the impact of a multifaceted intervention aimed at various healthcare professionals (HCPs) on antibiotic prescribing and dispensing for common infections.

Design And Setting: Before-and-after study set in general practice, out-of-hours services, nursing homes, and community pharmacies in France, Greece, Lithuania, Poland, and Spain.

Impact of Lung Ultrasound along with C-Reactive Protein Point-of-Care Testing on Clinical Decision-Making and Perceived Usefulness in Routine Healthcare for Patients with Lower Respiratory Tract Infections: Protocol for Analytical Observational Study.

: Lower respiratory tract infections (LRTIs) are a significant cause of primary care consultations. Differentiating between viral and bacterial infections is critical for effective treatment and to minimize unnecessary antibiotic use. This study investigates the impact of combining lung ultrasound (LUS) with capillary blood C-reactive protein (CRP) rapid testing on clinical decision-making for patients with LRTIs.

Diagnosing probable urinary tract infections in nursing home residents without indwelling catheters: a narrative review.

Background: Overdiagnosis of urinary tract infections (UTIs) is one of the most common reasons for the unnecessary use of antibiotics in nursing homes, increasing the risk of missing serious conditions. Various decision tools and algorithms aim to aid in UTI diagnosis and the initiation of antibiotic therapy for residents. However, due to the lack of a clear reference standard, these tools vary widely and can be complex, with some requiring urine testing.

C-reactive protein point-of-care testing in primary care-broader implementation needed to combat antimicrobial resistance.

This study presents the perspective of an international group of experts, providing an overview of existing models and policies and guidance to facilitate a proper and sustainable implementation of C-reactive protein point-of-care testing (CRP POCT) to support antibiotic prescribing decisions for respiratory tract infections (RTIs) with the aim to tackle antimicrobial resistance (AMR). AMR threatens to render life-saving antibiotics ineffective and is already costing millions of lives and billions of Euros worldwide. AMR is strongly correlated with the volume of antibiotics used.

Optimising antibiotic exposure by customising the duration of treatment for respiratory tract infections based on patient needs in primary care.

Primary care antimicrobial stewardship programs have limited success in reducing antibiotic use, prompting the search for new strategies. Convincing general practitioners to resist antibiotic prescription amid uncertainty or patient demands usually poses a significant challenge. Despite common practice, standard durations for common infections lack support from clinical studies.