Nigel P Stocks1, Tom Fahey. 1. Department of General Practice, University of Adelaide, South Australia. nigel.stocks@adelaide.edu.au
Abstract
BACKGROUND: In Australia and the UK acute bronchitis is a common presenting problem in general practice. When symptoms persist management can be difficult and despite evidence that antibiotics are usually ineffective their use is widespread. OBJECTIVE: To describe prescribing behaviour for acute bronchitis by general practitioners in the United Kingdom. METHOD: Cross sectional postal survey of UK GPs. RESULTS: Four hundred and nineteen (73%) GPs responded. Purulent sputum, fever and crepitations/crackles on chest examination were the most important reasons for prescribing antibiotics: 89% of GPs said the colour of the sputum influenced their decision; amoxycillin was the first choice; 40% of GPs believed that at least one in five consultations for ARI were affected by patient factors, usually to maintain patient satisfaction. 47% of GPs advised the use of bronchodilators, and 96% recommended the symptomatic use of paracetamol and fluids. CONCLUSION: General practitioners are influenced to use antibiotics by patient symptoms and signs for which there is little evidence. Patient psychosocial factors influence prescribing. Until clearer research findings from new studies are available, GPs may opt for a 'just in case' prescription.
BACKGROUND: In Australia and the UK acute bronchitis is a common presenting problem in general practice. When symptoms persist management can be difficult and despite evidence that antibiotics are usually ineffective their use is widespread. OBJECTIVE: To describe prescribing behaviour for acute bronchitis by general practitioners in the United Kingdom. METHOD: Cross sectional postal survey of UK GPs. RESULTS: Four hundred and nineteen (73%) GPs responded. Purulent sputum, fever and crepitations/crackles on chest examination were the most important reasons for prescribing antibiotics: 89% of GPs said the colour of the sputum influenced their decision; amoxycillin was the first choice; 40% of GPs believed that at least one in five consultations for ARI were affected by patient factors, usually to maintain patient satisfaction. 47% of GPs advised the use of bronchodilators, and 96% recommended the symptomatic use of paracetamol and fluids. CONCLUSION: General practitioners are influenced to use antibiotics by patient symptoms and signs for which there is little evidence. Patientpsychosocial factors influence prescribing. Until clearer research findings from new studies are available, GPs may opt for a 'just in case' prescription.