[Antibiotic prescription in acute respiratory infections in adults: its variability and appropriateness in 10 Spanish hospitals].
OBJECTIVE
To report the variability in antibiotic prescribing habits for patients diagnosed of non-specified acute respiratory infections (ARI) (according to the International Classification of Diseases 9MC) at Emergency Departments of ten Spanish hospitals, and to evaluate the appropriateness of antimicrobial prescription for such patients, after specifically elaborating some reference patterns for appropriate antimicrobial use.


METHODS
Descriptive study of variability in clinical practice by means of a prospective series of cases. Study of appropriateness by means of elaborating reference standards for appropriate use and comparison with the data from the descriptive study with such standards.


METHODS
six months.


METHODS
Emergency Department in ten Spanish hospitals from different autonomic communities: Andalucía, Islas Canarias, Castilla-León, Cataluña, Galicia, Madrid, Murcia and Valencia for a 6-month period.


METHODS
Patients with the diagnosis of community ARI attended at emergency departments.


METHODS
903 cases.


METHODS
Collection of cases in a unified database with the following variables: age, sex, ARI type, diagnosis of comorbidity, prescribed antimicrobial, hospital admission and type of prescriber. A panel of experts was commissioned to elaborate the gold standards for the appropriate use of antibiotics or the lack of indication for the different locations of ARI.


RESULTS
The adjusted proportion of the inappropriate prescription for the group with laryngo-tracheal-influenza-rhinopharyngitis-multiple ARI or non specified infections was 67.9%.


CONCLUSIONS
Concerning antibiotic prescription, significant inter-center variability and relevant heterogeneity were observed.
Inglada Galiana
L
L
Servicio de Medicina Interna, Hospital Medina del Campo, Valladolid.
Eiros Bouza
J M
JM
Ochoa Sangrador
C
C
Vallano Ferraz
A
A
Armadans Gil
L
L
Vidal Bugallo
J B
JB
Artero Mora
A
A
Ruiz Cantero
A
A
Cerdá Mota
T
T
Lázaro Asensio
A
A
Martínez López
A
A
Guerra Romero
L
L
D000208:Acute Disease; D000293:Adolescent; D000328:Adult; D000367:Age Factors; D000368:Aged; D000369:Aged, 80 and over; D000900:Anti-Bacterial Agents / Q000627:therapeutic use*; D011307:Drug Prescriptions; D005260:Female; D006801:Humans; D007297:Inpatients; D008297:Male; D008875:Middle Aged; D011446:Prospective Studies; D012141:Respiratory Tract Infections / Q000188:drug therapy*; D012737:Sex Factors; D013030:Spain
D000900:Anti-Bacterial Agents