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ORIGINAL RESEARCH article

Front. Med.
Sec. Family Medicine and Primary Care
Volume 11 - 2024 | doi: 10.3389/fmed.2024.1440632
This article is part of the Research Topic The Increasing Relevance of Traditional Medicine Systems for the Primary Health Care Sector and General Practice: Global Research Perspectives View all 16 articles

Exploring the Association Between Phytopharmaceutical Use and Antibiotic Prescriptions in Upper Respiratory Infections: Results from a German Cohort Study Evaluating the Impact of Naturopathy Qualifications of General Practitioners Using Routine Data

Provisionally accepted
Anna-Jasmin Wetzel Anna-Jasmin Wetzel 1*Gunter Laux Gunter Laux 2Berthold Musselmann Berthold Musselmann 3Stefanie Joos Stefanie Joos 1Jan Valentini Jan Valentini 1*
  • 1 Institute of General Practice and Interprofessional Care, University Hospital and Faculty of Medicine, University of Tübingen, Tübingen, Germany
  • 2 Department of General Medicine and Health Service, Heidelberg University Hospital, Heidelberg, Baden-Württemberg, Germany
  • 3 Other, Wiesloch, Germany

The final, formatted version of the article will be published soon.

    Background: Antibiotic resistance is a significant global health threat, exacerbated by inappropriate prescribing practices, particularly for upper respiratory infections that are predominantly viral. Complementary and Integrative Medicine (CIM), including the use of phytopharmaceuticals, offers a potential strategy to reduce antibiotic prescriptions.Objective: This study aimed to describe the impact of General Practitioners' (GPs) naturopathy (NP) qualifications and phytopharmaceutical prescriptions on the rate of antibiotic prescribing for upper respiratory infections (RTI).Methods: We conducted a retrospective cohort study using routine data from the CONTinuous morbidity registration Epidemiologic NeTwork (CONTENT), which includes over 200,000 patients across four federal states in Germany. The study included data from n=36 GPs who recorded at least one ICD-10 diagnosis of RTI. Antibiotic and phytopharmaceutical prescriptions were identified and analyzed through mixed-effects logistic regression models to explore the influence of GPs' naturopathy qualifications and phytopharmaceutical use on antibiotic prescribing patterns.Results: The study included 40,344 patients managed by 36 GPs. Prescriptions of phytopharmaceuticals significantly reduced the likelihood of antibiotic use (OR 0.48, 95% CI 0.45-0.52). Additionally, holding a naturopathy qualification was associated with lower rates of antibiotic prescriptions (OR 0.73, 95% CI 0.69-0.78). The interaction between naturopathy qualification and phytopharmaceutical prescriptions also showed a significant effect (OR 1.43, 95% CI 1.27-1.62). Patient's year of birth influenced prescribing patterns indicating a reduction of antibiotic prescriptions for younger patients, while patients' gender did not reveal a significant effect.Conclusions: Prescriptions of phytopharmaceuticals were significantly associated with a decrease antibiotic prescriptions among GPs, especially when combined with naturopathy qualifications. Training in naturopathic approaches could enhance antibiotic stewardship efforts in primary care settings, suggesting that broader integration of CIM elements into medical training could be beneficial in mitigating antibiotic resistance.

    Keywords: antibiotic resistance, phytopharmaceuticals, phytotherapeutica, complementary and integrative medicine, Naturopathy, Upper respiratory infections, cohort study, Primary Care

    Received: 29 May 2024; Accepted: 23 Sep 2024.

    Copyright: © 2024 Wetzel, Laux, Musselmann, Joos and Valentini. This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) or licensor are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.

    * Correspondence:
    Anna-Jasmin Wetzel, Institute of General Practice and Interprofessional Care, University Hospital and Faculty of Medicine, University of Tübingen, Tübingen, Germany
    Jan Valentini, Institute of General Practice and Interprofessional Care, University Hospital and Faculty of Medicine, University of Tübingen, Tübingen, Germany

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