Delayed antibiotic therapy in general practice: example of acute otitis media in adults and children over 6 months of age. Study protocol

Introduction. In 2019, France was the 4th largest consumer of antibiotics in Europe. Delayed prescription would reduce antibiotics consumption, but its effectiveness is poorly studied in the literature, never in France. Our main objective is to study the factors associated with the choice of antibiotic strategy (immediate or delayed). Our secondary objectives are to study the frequency and factors associated with antibiotic consumption according to the initial prescription, and to determine the typical profiles of patients, in the context of a delayed prescription, who consume the antibiotic outside the physician's recommendations. Methods and analysis. This is an observational study. Between September 2022 and may 2024, 330 Ile-de-France general practitioners will recruit 2800 patients over 6 months of age with acute otitis media. GPs will be recruited via the CNGE investigators' network, the colleges of general practice, the Sentinel network, the French medical council and the regional unions of health professionals. Initial medical data will be collected by physicians. Patients will fill in daily data for two weeks to monitor their disease. They will complete social data, as well as questionnaires assessing their level of health knowledge, confidence and satisfaction with the general practitioner consulted. Factors associated with the choice of antibiotic therapy by the physician and the consumption of antibiotics by the patients will be analyzed via mixed models. Consumption rates will be expressed as percentages with their confidence intervals. Conclusion. This work will allow for a better understanding of the elements that guide physicians to prescribe antibiotics. It may help physicians to better assess patients who are likely to be non-compliant with delayed prescription in order to avoid this type of prescription for them.