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Table 2 Elements of the clinical situation that result in the decision to prescribe or not prescribe antibiotics for urinary tract infections, respiratory tract infections, and skin infections

From: Factors influencing antibiotic prescribing in long-term care facilities: a qualitative in-depth study

Clinical situation Antibiotic Urinary tract infection Respiratory tract infection Skin infection
Current YES Signs and symptoms (or a high risk of signs and symptoms), positive dipstick test (for leukocyte esterase, nitrite, or both)/dipslide/culture, patient experiences burden, patient feels ill, hematuria, vulnerability of the patient, comorbidity, no prior antibiotic resistance Signs and symptoms, patient feels ill, vulnerability of the patient, risk of death, comorbidity Signs and symptoms, vulnerability of the patient
NO Absence of (relevant) signs and symptoms whether or not in combination with a positive dipstick test (for leukocyte esterase, nitrite, or both), negative dipstick test, awaiting culture results in case of no/minimal signs and symptoms, patient does not feel ill, poor prognosis, acceptance of resistant bacteria in urine Poor prognosis, suspected viral infection, no/minimal signs and symptoms, patient does not feel (severely) ill, physical inability to take oral medication, allowing immune system of the patient to clear infection Absence of (relevant) signs and symptoms
Medical history YES Positive effect of treatment for previous infection, no/limited history of infection, ineffective previous treatment Severe course of previous infection -
NO - No history of infection -