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
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 | - |