Prescribing systemic antibiotics in general practice. A report from the Møre & Romsdal Prescription Study.
OBJECTIVE
To describe general practitioners' (GPs) prescribing patterns for antibiotics and to compare them with therapeutic guidelines.


METHODS
Cross-sectional, observational study.


METHODS
In the Norwegian county Møre & Romsdal the GPs recorded all contacts with patients and prescriptions during two months.


METHODS
69,843 contacts with 56,758 prescriptions, of which 7905 were for systemic antibiotics.


METHODS
Prescriptions in relation to diagnosis, kind of consultation, and patients' age and sex.


RESULTS
61% of all antibiotic prescriptions were for females, 26% were issued during indirect contacts, and 14% were repeat prescriptions. Phenoxymethylpenicillin was prescribed most frequently (32%), followed by co-trimoxazole (19%), tetracyclines (18%), erythromycin (16%), and penicillins with extended spectrum (6%). Urinary tract infection was the most frequent diagnosis for antibiotic prescribing (24%), followed by acute bronchitis (13%), ear infections (9%), upper respiratory tract infections (8%), and acute tonsillitis (8.2%). A regression analysis showed that first-time consultations for tonsillitis and otitis, but not for acute bronchitis and pneumonia, patient age 13-64 years, female physician, urban practice location, and a fixed. GP salary were associated with the prescribing of phenoxymethylpenicillin in contrast to other antibiotics.


CONCLUSIONS
Antibiotics are often prescribed for viral infections (e.g., acute bronchitis). Broad spectrum antibiotics are often prescribed for diagnoses where penicillin is recommended as first choice. The issue of antibiotic misuse should be addressed more explicitly in general practice.
Department of Public Health and Primary Health Care, University of Bergen, Norway.
J
J
Straand
K S
KS
Rokstad
H
H
Sandvik
D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000900:Anti-Bacterial Agents / Q000627:therapeutic use*; D002648:Child; D002675:Child, Preschool; D003430:Cross-Sectional Studies; D011307:Drug Prescriptions / Q000706:statistics & numerical data*; D004363:Drug Utilization; D005194:Family Practice / Q000706:statistics & numerical data*; D005260:Female; D006801:Humans; D007223:Infant; D008297:Male; D008875:Middle Aged; D009664:Norway; D010404:Penicillin V / Q000627:therapeutic use; D012017:Referral and Consultation / Q000706:statistics & numerical data; D012141:Respiratory Tract Infections / Q000188:drug therapy / Q000453:epidemiology; D016896:Treatment Outcome
D000900:Anti-Bacterial Agents; D010404:Penicillin V