Antibiotic prescription, course of therapy and treatment costs in conventional and complementary primary care in the treatment of acute upper respiratory tract infections

26kgg137 10.3205/26kgg137 urn:nbn:de:0183-26kgg1374 Meeting Abstract Antibiotic prescription, course of therapy and treatment costs in conventional and complementary primary care in the treatment of acute upper respiratory tract infections – a non-interventional study Reif Reif Marcus M

Gesellschaft für Klinische Forschung e.V., Deutschland

author Martin Martin David D

Universität Witten/Herdecke, Deutschland

author Baumgartner Baumgartner Stephan S

Gesellschaft für Klinische Forschung e.V., Deutschland Universität Witten/Herdecke, Deutschland

author German Medical Science GMS Publishing House

Düsseldorf

610 20251030 engl This is an Open Access article distributed under the terms of the Creative Commons Attribution 4.0 License. Dieser Artikel ist ein Open-Access-Artikel und steht unter den Lizenzbedingungen der Creative Commons Attribution 4.0 License (Namensnennung). M0662 137 Deutsche Gesellschaft für Allgemeinmedizin und Familienmedizin Deutsche Gesellschaft für Sozialmedizin und Prävention Netzwerk Evidenzbasierte Medizin e.V. Deutsche Gesellschaft für Medizinische Soziologie 60. Kongress für Allgemeinmedizin und Familienmedizin Gesundheit gestalten Akute und postakute Infektionssyndrome Göttingen 20260930 20261002 V-25-01 TextBackground: In 2019, the World Health Organization ranked anti-microbial resistance (AMR) among the 10 greatest global threats to public health. Since 2016, the Innovation Committee of the G-BA aims to sensitize physicians for a restrictive use of antibiotics. In parallel, research on existing non-antibiotic medicines can support strategies to combat AMR.Aim/scientific question: For treating acute upper respiratory tract infections and otitis media (URTI/AO) antibiotics are often unnecessary but still frequently used. We examined the current incidence of antibiotics in primary care and whether URTI/AO patients treated in homeopathic/anthroposophic ('H/A') practices, which strictly avoid antibiotics, show at least as good recovery as in conventional ('Con') practices.Material & Methods: In a non-interventional, prospective, controlled study, German family medicine, pediatric, and ENT primary care practices declared themselves as H/A or Con. URTI/AO patients with public health insurance aged 6 months or older (or their legal guardians) consented to the collection of their clinical and treatment data and completed symptom and quality-of-life questionnaires at the current visit, 7 days later, and a daily symptom diary for up to 28 days; also, therapy costs were assessed. Primary outcome was the proportion of patients reporting complete/substantial recovery after 7 days. Statistical analysis for non-inferiority of H/A practices (threshold 5%) was based on causal inference models and Inverse Probability of Treatment Weighting. Relevant confounders were identified by independent experts to balance the study arms against systematic bias of non-random patient allocation.Results: Between May 2025 and March 2026, 747 patients were recruited and 636 analyzed. Confounder balance was achieved. Antibiotics were prescribed for 16.1% and 3.6% of patients in Con and H/A practices, respectively; complete/major recovery was stated in 72.4% and 79.3%, respectively. Causal analysis revealed odds ratios for the recovery rate of H/A practices of 1.28 (95%-CI: 0.88-1.87) and 1.29 (0.88-1.88) for Per Protocol and Full Analysis Set, respectively, confirming non-inferiority compared to Con practices.Discussion: The G-BA programs for reduction of antibiotic treatment of acute URTI seem to have succeeded to lower their prescription rates, yet strict non-antibiotic therapy strategies followed in H/A practices may be at least not inferior to current therapies in Con practices.Take Home Message: Further reduction of antibiotics in URTI is both necessary and possible.Competing interests: Marcus Reif is a member of the IBS-DR and the DGPharMed. David Martin provided pro bono project-related consulting to the RKI and the BMBFSFJ, is a member of scientific advisory boards (Hufeland Society, Pharmacovigilance Commission of the BfArM), and receives travel expense reimbursement for speaking engagements (BVKJ, DGKJ, DGHNO-KHC, DGÖG, BVÖGD, DGAAP) as well as third-party funding for research projects from the BMBF, the G-BA Innovation Fund, and the Software AG Foundation. Stephan Baumgartner is a member of scientific societies (ISCMR, ESIM, VAEPS, WissHom, DPG). 0 0 0 0