Empirical first-line antibioticotherapy in adult rural patients with acute respiratory tract infections.

The objective of the study was the evaluation of the frequency of occurrence of acute respiratory infections among rural population from the Lublin Region, and verification of the appropriateness of the use of antibiotics in empirical first-line therapy of these diseases. The analysis covered medical records concerning 1,839 patients selected from 27 rural health centres within the period of one year (1 September 2005-31 August 2006). As many as 656 patient visits were recorded, the reasons for which were qualified by physicians as infections of the upper and lower airways. These disorders were diagnosed in 450 patients, which constituted 24.46% of the population examined. The following diagnoses were most frequently made: acute pharyngitis and tonsillitis (31.25% of the total number of diagnoses), acute upper respiratory infections of multiple and unspecified sites (22.25%), and common cold (21.64%). Antibiotics were used in empirical first-line therapy in as many as 82% of the total number of patients. The analysis showed that in the great majority of cases the use of antibiotics was inappropriate. If this situation persists, in the near future it will lead to an increase in the phenomenon of antibiotic resistance in Poland. In order to prevent this situation, it is necessary to carry out an extensive educational action concerning the hazardous effect of excessive use of antibiotics, both among physicians and the whole society.