[Are antibiotics correctly prescribed in primary care?]

To identify the antibiotic prescriptions and evaluate their suitability for the infectious conditions treated at a Primary Care Centre.

A prospective observation study.

La Mina Primary Care Centre. Sant Adrià de Besòs (Barcelona).

The on-demand visits of patients over 14 to the General Medicine and Emergency clinics between June 1991 and May 1992 provided the data through a simple multi-stage random sample.

On the basis of the clinical notes, these variables were recorded: age, gender, diagnosis, the antibiotic prescribed and its manner of administration. The indication and choice of treatment was assessed in line with previously established criteria, as well as whether the antibiotic was first-choice in Primary Care. Infections treated in hospital or by specialists, non-bacterial cutaneous infections and Conjunctivitis were excluded. Out of 2,523 people examined, 474 presented infectious conditions (18.8%); the most common of these were infections of the upper respiratory tract (46.4%) and acute Bronchitis (17.3%). An antibiotic was prescribed in 206 cases (43.3%). The most used antibiotics were: Amoxicillin (41.5%), Penicillin (19.0%), Cloxacillin (11.2%), Erythromycin (10.2%) and Pipemidic Acid (7.8%). They were orally taken in 89.4% of cases. 92.3% of the antibiotics were first-choice. Overall fitness of treatment was 86.3% (56.5% unnecessary and non-prescribed treatment; and 29.7% necessary and using the recommended antibiotic). The least suitable treatment was observed for cases of acute Bronchitis without any risk factors.

Prescriptions are adjusted to the recommendations on antibiotic policy in Primary Care, although less suitable treatment was observed for acute Bronchitis. The importance of applying a methodology based on objective criteria, in order to make a qualitative analysis in studies on the use of medication, is highlighted.