Upper respiratory tract infections in general practice: diagnosis, antibiotic prescribing, duration of symptoms and use of diagnostic tests.
A diagnosis/antibiotic prescribing study was performed in 5 counties in Sweden for 1 week in November 2000. As part of this study, the characteristics and clinical management of patients with upper respiratory tract infections (n = 2899) in primary care were analyzed. Almost half of the patients were aged < 15 y and one-fifth of the patients consulted out of hours. Of all patients seeking primary care for upper respiratory tract infections, 56.0% were prescribed an antibiotic. Almost all patients who were given the diagnoses streptococcal tonsillitis, acute otitis media or acute sinusitis were prescribed antibiotics, compared to 10% of patients with common cold or acute pharyngitis. The most frequently prescribed antibiotic was penicillin V (79.2%) and this was even more pronounced out of hours, when the diagnoses otitis media and streptococcal tonsillitis were more frequently used. In patients with common cold and acute pharyngitis, the percentage who received antibiotics increased with increasing length of symptoms and increasing CRP levels. In patients with acute pharyngitis or streptococcal tonsillitis, antibiotics were prescribed less frequently provided streptococcal tests were performed. The management of patients with upper respiratory tract infections in general practice seems to be in good agreement with current Swedish guidelines. However, the study indicates some areas for improvement. The diagnosis of acute sinusitis seems to have been overestimated and used only to justify antibiotic treatment.
André
Malin
M
Center for Clinical Research, Falun, Sweden.
Odenholt
Inga
I
Schwan
Ake
A
Axelsson
Inge
I
Eriksson
Margareta
M
Hoffman
Mikael
M
Mölstad
Sigvard
S
Runehagen
Arne
A
Lundborg
Cecilia Stålsby
CS
Wahlström
Rolf
R
D000208:Acute Disease; D000293:Adolescent; D000328:Adult; D000368:Aged; D000900:Anti-Bacterial Agents / Q000627:therapeutic use*; D002675:Child, Preschool; D003139:Common Cold / Q000188:drug therapy; D003955:Diagnostic Tests, Routine; D011307:Drug Prescriptions; D005194:Family Practice; D005260:Female; D006801:Humans; D007231:Infant, Newborn; D008297:Male; D008875:Middle Aged; D010033:Otitis Media / Q000188:drug therapy; D010612:Pharyngitis / Q000188:drug therapy; D010818:Practice Patterns, Physicians'; D012141:Respiratory Tract Infections / Q000175:diagnosis* / Q000188:drug therapy*; D012852:Sinusitis / Q000188:drug therapy; D014069:Tonsillitis / Q000188:drug therapy
D000900:Anti-Bacterial Agents