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Marked differences in GPs' diagnosis of pneumonia between Denmark and Spain: a cross-sectional study

Sarah Friis Christensen1, Lars Christian Jørgensen, Gloria Cordoba

  • 1Section of General Practice and Research Unit for General Practice, Department of Public Health, University of Copenhagen, Copenhagen, Denmark.

Primary Care Respiratory Journal : Journal of the General Practice Airways Group
|November 20, 2013
PubMed
Abstract

Insights

Diagnoses of pneumonia in lower respiratory tract infections (LRTI) varied significantly between Denmark and Spain. Differences in diagnostic criteria may contribute to antibiotic overprescribing, particularly in Denmark.

Area of Science:

  • General Practice
  • Infectious Diseases
  • Antibiotic Stewardship

Background:

  • Identifying appropriate antibiotic use for lower respiratory tract infections (LRTI) is challenging.
  • International guidelines differentiate treatment for pneumonia versus acute bronchitis.
  • Overdiagnosis of pneumonia can lead to unnecessary antibiotic prescribing.

Purpose of the Study:

  • Compare pneumonia prevalence in LRTI patients between Denmark and Spain, countries with differing antibiotic prescribing rates.
  • Identify key symptoms and clinical findings influencing general practitioners' (GPs) pneumonia diagnosis over acute bronchitis.

Main Methods:

  • Cross-sectional study within the EU-funded HAPPY AUDIT project.
  • Inclusion of 2,698 patients diagnosed with LRTI.
  • Data collected from GPs in Denmark and Spain.

Main Results:

  • Pneumonia prevalence in LRTI was 47% in Denmark versus 11% in Spain.
  • Spanish GPs prioritized fever and positive X-ray for pneumonia diagnosis.
  • Danish GPs placed greater importance on dyspnea/tachypnea and elevated C-reactive protein (>50mg/L).

Conclusions:

  • Significant differences exist in GPs' diagnostic criteria for pneumonia between Denmark and Spain.
  • High pneumonia prevalence in Danish LRTI patients suggests potential overdiagnosis.
  • This overdiagnosis may contribute to increased antibiotic prescribing rates.

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