Literature DB >> 18544602

Antibiotics for respiratory, ear and urinary tract disorders and consistency among GPs.

David S Y Ong1, Marijke M Kuyvenhoven, Liset van Dijk, Theo J M Verheij.   

Abstract

OBJECTIVES: To describe specific diagnoses for which systemic antibiotics are prescribed, to assess adherence of antibiotic choice to national guidelines and to assess consistency among general practitioners (GPs) in prescribed volumes of antibiotics for respiratory, ear and urinary tract disorders.
METHODS: The cross-sectional study included 174 GPs from 89 general practices. Data were derived from the Second Dutch National Survey of General Practice (DNSGP-2) in 2001. Outcome measures were the antibiotic prescriptions for respiratory, ear and urinary tract disorders defined according to the International Classification of Primary Care codes, the percentage of first-choice antibiotics complying with national guidelines and the number of antibiotic prescriptions per 1000 patients per GP per year.
RESULTS: The most antibiotics for respiratory tract infection (RTI) were prescribed for acute bronchitis (25%), sinusitis (22%) and acute upper RTI (14%). The most antibiotics were prescribed for acute otitis media (77% of ear disorders) and cystitis (95% of urinary tract disorders). First-choice antibiotics were prescribed in approximately 75% of the cases, whereas macrolides and amoxicillin/clavulanate (second-choice antibiotics) were prescribed in approximately 25%, especially in lower RTIs. The correlations (Spearman rho) between prescribed volumes for the three main groups of disorders varied from 0.39 to 0.67.
CONCLUSIONS: GPs were consistent in prescribing antibiotics for the three groups of diseases. Improvement strategies should focus on the management of acute upper RTIs and acute bronchitis and also on the use of amoxicillin/clavulanate and macrolides, these being mostly second-choice antibiotics in national guidelines.

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Year:  2008        PMID: 18544602     DOI: 10.1093/jac/dkn230

Source DB:  PubMed          Journal:  J Antimicrob Chemother        ISSN: 0305-7453            Impact factor:   5.790


  22 in total

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Review 2.  Effectiveness of physician-targeted interventions to improve antibiotic use for respiratory tract infections.

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4.  Potential for reducing inappropriate antibiotic prescribing in English primary care.

Authors:  Timo Smieszek; Koen B Pouwels; F Christiaan K Dolk; David R M Smith; Susan Hopkins; Mike Sharland; Alastair D Hay; Michael V Moore; Julie V Robotham
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5.  Variation in antibiotic prescriptions: is area deprivation an explanation? Analysis of 1.2 million children in Germany.

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7.  Point-of-care urine culture for managing urinary tract infection in primary care: a randomised controlled trial of clinical and cost-effectiveness.

Authors:  Christopher C Butler; Nick A Francis; Emma Thomas-Jones; Mirella Longo; Mandy Wootton; Carl Llor; Paul Little; Michael Moore; Janine Bates; Timothy Pickles; Nigel Kirby; David Gillespie; Kate Rumsby; Curt Brugman; Micaela Gal; Kerenza Hood; Theo Verheij
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8.  Effect of pravastatin and fosinopril on recurrent urinary tract infections.

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9.  Immediate versus conditional treatment of uncomplicated urinary tract infection - a randomized-controlled comparative effectiveness study in general practices.

Authors:  Ildikó Gágyor; Eva Hummers-Pradier; Michael M Kochen; Guido Schmiemann; Karl Wegscheider; Jutta Bleidorn
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10.  Antibiotic prescribing in primary care, adherence to guidelines and unnecessary prescribing--an Irish perspective.

Authors:  Marion Murphy; Colin P Bradley; Stephen Byrne
Journal:  BMC Fam Pract       Date:  2012-05-28       Impact factor: 2.497

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