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Macrolide overuse for treatment of respiratory tract infections in general practice

Mette Hinnerskov1, Julie Maria Therkildsen, Gloria Cordoba

  • 1Section of General Practice, University of Copenhagen, Denmark. Mette_Stengaard@hotmail.com

Danish Medical Bulletin
|November 4, 2011
PubMed
Abstract

Insights

Macrolide antibiotics were frequently overprescribed for respiratory tract infections (RTIs) in Denmark, even when patients did not have penicillin allergies. This overuse occurred despite penicillin being the recommended first-line treatment for most RTIs.

Area of Science:

  • Infectious Diseases
  • Pharmacology
  • Public Health

Background:

  • High macrolide consumption is linked to increased resistance in respiratory tract infection (RTI) pathogens.
  • Danish guidelines recommend penicillin as first-choice for RTIs, reserving macrolides for penicillin-allergic patients or Mycoplasma pneumoniae infections.
  • This study investigated macrolide prescription patterns for RTIs in patients without penicillin allergy in Danish general practice.

Purpose of the Study:

  • To analyze the prescription of macrolides for various RTIs in patients without penicillin allergy in Danish general practice.
  • To identify specific RTIs where macrolide overuse is most prevalent.

Main Methods:

  • A cross-sectional study conducted in January 2008.
  • Data collected from 102 Danish general practitioners as part of the EU-funded HAPPY AUDIT project.
  • Utilized the Audit Project Odense method for registering patients with RTIs.

Main Results:

  • Out of 3,904 registered RTI patients, 1,351 received antibiotics, and 198 received macrolides.
  • 136 patients received macrolides without a penicillin allergy.
  • Macrolide overuse was highest in acute otitis media (71%), acute bronchitis (71%), and pneumonia (76%).

Conclusions:

  • A considerable overuse of macrolides for treating various RTIs was observed in Danish general practice.
  • The observed macrolide overuse cannot be attributed to Mycoplasma pneumoniae infections, as no epidemic was present in 2008.
  • Findings highlight a need for improved adherence to antibiotic prescribing guidelines for RTIs to combat antimicrobial resistance.

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