The antibiotic prescribing behaviourof physicians for acute tonsillopharyngitis in primary care

Acute tonsillopharyngitis is one of the most common reasons for antibiotic use although it is mostly viral. There seems to be a large variation between physicians in prescribing antibiotics. The aim of this study was to explore the antibiotic prescribing behaviour of physicians while treating cases with acute tonsillopharyngitis.

Data were collected using a questionnaire designed to investigate the effect of the antibiotics actively promoted by pharmaceutical companies, the sociodemographic details of primary care physicians, the geographic location (urban-rural) of the primary care organizations, and the effect of laboratory investigations on provider antibiotic prescribing behaviour in the treatment of acute tonsillopharyngitis. Sixty six primary care organisations (PCOs) and 316 primary care physicians working in the 66 PCOs in Adana in 2001 were involved in the study.

Out of 66 PCOs, 55 (83%) were urban and 11 (16%) were rural. The response rate was 79%. There was significant association between antibiotic prescription for acute tonsillopharyngitis and geographic location, antibiotic promotion by pharmaceutical companies and postgraduate training for physicians (p = 0.001, p = 0.0001, p = 0.0001, respectively). There was also significant association between laboratory investigation and geographic location, postgraduate training for physicians, and period since graduation (p = 0.0001, p = 0.0001, p = 0.003, respectively).

Antibiotics in cases with acute tonsillopharygitis are more frequently prescribed in rural areas and in PCOs where the visits and motivation from pharmaceutical companies are intensive. Physicians without postgraduate vocational training prescribe more antibiotics for cases with acute tonsillopharyngitis.