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[Antibiotics prescription in ambulatory patient]
A Alvarez Carrera1, C Martínez Cantarero, A Vidal Oliveras
1Dirección de Atención Primaria (DAP) Bages-Berguedà-Solsonès. Institut Català de la Salut. España. asun.alvarez@manresa.scs.es
Objective:
To find what antibiotics are prescibed for common infections in adult and paediatric primary care patients.
Design:
Drug utilization (DU) study: cross-sectional and observational design.
Setting:
Primary care centres and hospital casualty departments in Bages and Berguedà counties (total population: 198 129 inhabitants).
Participants:
Adults and children with acute respiratory infection, acute otitis media, acute pharyngitis, acute tonsillitis, or acute bronchitis and flu syndrome; adults only with acute sinusitis, attacks of chronic obstructive pulmonary disease (COPD) or urinary infections.
Main Measurements And Results:
1596 episodes from November 1999 to February 2000 were collected. 975 (61%) of these were in adults, and 621 (3996) in children. Of the infections of mainly viral aetilogy, those most commonly treated with antibiotics were acute Bronchitis, in both adults (76.096 [95% CI, 67.6%-84.2%]) and children (60296 [95% CI, 50.0%-70.5%]). The most common antibiotics were: amoxycillin/clavulanic acid for otitis (34%), sinusitis (37%) and tonsillitis (44%) in adults macrolides in attacks of COPD (4096) and tonsillitis (33%) in children; quinolones for urinary infections (56%), and cefalor for otitis in children (2096).
Conclusions:
Local policy measures need to be taken to improve use of antibiotics for primary care patients. DU studies are extremely useful, as their description of the pattern of prescription enables concrete problems to be detected.