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Acute bronchitis in Australian general practice. A prescription too far?
Nigel P Stocks1, Heather McElroy, Geoffrey P Sayer
1Department of General Practice, University of Adelaide, South Australia. nigel.stocks@adelaide.edu.au
Objective:
To quantify how frequently general practitioners in Australia prescribe antibiotics for acute bronchitis, which antibiotics are used, and whether there are subgroups of patients who might benefit from their use.
Design And Setting:
A retrospective descriptive study using 3 sets of data: Australian Sentinel Practice Research Network, the Bettering the Evaluation and Care of Health (BEACH) Program, and the General Practice Research Network (GPRN).
Results:
Over 50% of all patients with 'acute bronchitis' had either chest or one or more systemic signs on physical examination. The rate of antibiotic prescribing for acute bronchitis was 79.6% of acute bronchitis visits using BEACH data 2001-2002 and varied from 68.6 (95% CI: 62.8-74.5%) in 2001 to 78.7 (95% CI: 72.2-85.2%) in 1999 using GPRN data. Penicillins, followed by macrolides, were the most commonly prescribed antibiotics.
Discussion:
Australian GPs frequently prescribe antibiotics for 'acute bronchitis' despite guidelines to the contrary. One reason may be that many patients present with chest or systemic signs.