[Suitability of antibiotic prescription in primary care in the Basque Autonomous Community].
OBJECTIVE
To study the variability and suitability of antibiotic prescription in primary care in the Basque Country.


METHODS
Prospective, descriptive study.


METHODS
Basque Country health care centres both within and not in the reformed network.


RESULTS
3182 infections from consultations for infectious disease were studied through sampling stratified by health area during February, March and April 1998. The appropriateness of antibiotics (ATB) prescription was compared with some standards after an extensive bibliographic review. 68.6% of consultations were infections not needing ATB (infections of respiratory airways, acute bronchitis, flu and gastro-enteritis). ATB were used in 28.5% of these cases (CI: 26.6-30.5), especially in acute bronchitis (90.7%) (CI: 87.3-93.4). Unnecessary prescription supposes 39.7% of total antibiotic prescription (CI: 37.2-42.1%), which means unnecessary annual expenditure of 1155 million pesetas. In 31.4% of the infections that require ATB treatment, in 23.7% inappropriate treatment was chosen (CI: 21-26.7%). Overall appropriateness of treatment was 72.2% (CI: 70.6-73.8). Working in the reformed system was linked to better prescription in all cases. Paediatricians prescribed better in the case of infections not susceptible to ATB treatment.


CONCLUSIONS
ATB prescription is not consistent with the available scientific evidence. Incorrect treatments occur especially in benign and self-limiting processes. A local policy of ATB use that includes multi-disciplinary collaboration and effective ongoing training is necessary.
Rotaeche del Campo
R
R
Centros de Salud de Alza y Hernani. Comarca Guipúzcoa Este. Complejo Hospitalario Donostia. San Sebastián. Médico de Familia. rrotaechec@nexo.es
Vicente Anza
D
D
Mozo Avellaned
C
C
Etxeberria Agirre
A
A
López Navares
L
L
Olasagasti Caballero
C
C
Barandiaran Forcada
M
M
Iturrioz Rosell
P
P
Larrañaga Padilla
M
M
Valverde Bilbao
E
E
D000328:Adult; D000900:Anti-Bacterial Agents / Q000627:therapeutic use*; D002648:Child; D004363:Drug Utilization / Q000592:standards; D006801:Humans; D011320:Primary Health Care; D011446:Prospective Studies; D013030:Spain; D011795:Surveys and Questionnaires
D000900:Anti-Bacterial Agents