[Importance of professional proposals in the era of broadening antibiotic resistance].
A great degree of neglection has been portrayed on the consideration in two most important professional proposals in 6906 patients of 44 praxis in the basic health care in 1996: 1. the obviously viral respiratory diseases (including acute bronchitis, ordinarily) was treated in 56% of cases with antibacterial drugs (in 83% of all treatments with broad spectrum antibiotics), and 2. for patients with Streptococcal infections too broadened spectrum antibiotics for this purpose were undesirably prescribed (in 75.5% of treatments) by physicians. Taking into consideration the suitable efficient ("evidence based") anticausal therapy and professional proposals, as well, in 63.6% of all antibiotic therapy could be avoided by physicians. By all means, these prescribed legion of the aimless, unnecessary and simultaneously too broadened spectrum antibacterial drugs served for the spreading of antibiotic resistance only, and all of them were the results of the neglection of the most important professional proposals. These unnecessary treatments--excluding the increase of resistance or the improper, unsubstantiated raise in hopes of patients--cost too much: the sum of expenses were 49.5% of the cost for antibiotics in Hungary in 1996 (in our estimation). To measure and examine periodically the quality level of primary infectological care, new quality indicators were appointed by the authors: the attained quality levels of each medical praxis would have to be compared and approached to the desirable level of quality indicators (reflecting the "evidence based" infections care) for the abolition of the unreasonable, expensive and dangerous practice for patients, as well. It appears, that the wide application of the appropriate, "evidence based" anticausal therapy would be reached with control of offered quality (the offered values of the quality indicators) of physicians in primary care, only. The introduction of quality assurance in basic health care needs urgent comprehensive official action.
Katona
Z
Z
Kalocsai Kórház, Csecsemó- és Gyermekosztály, Budapest.
Molnár
I
I
D000900:Anti-Bacterial Agents / Q000191:economics / Q000627:therapeutic use; D000075202:Contraindications; D004352:Drug Resistance, Microbial; D004363:Drug Utilization / Q000706:statistics & numerical data; D019317:Evidence-Based Medicine; D006801:Humans; D006814:Hungary; D010818:Practice Patterns, Physicians' / Q000706:statistics & numerical data / Q000639:trends; D012141:Respiratory Tract Infections / Q000188:drug therapy* / Q000191:economics / Q000821:virology*
D000900:Anti-Bacterial Agents