Prescribing antibiotics for respiratory tract infections by GPs: management and prescriber characteristics.
BACKGROUND
Due to clinical and non-clinical factors, considerable variation exists in the prescribing of antibiotics for respiratory tract infections (RTIs) by GPs based in the Netherlands.


OBJECTIVE
To assess, in patients with RTIs in Dutch general practice: the prescribing rates of antibiotics; the relationship between GP characteristics and antibiotic prescribing; and the type of antibiotics prescribed.


METHODS
Descriptive and prognostic.


METHODS
Eighty-four GPs in the middle region of the Netherlands.


METHODS
All patient consultations for RTIs were registered by 84 GPs during 3 weeks in autumn and winter 2001 and 2002. In addition, all GPs completed a questionnaire related to individual and practice characteristics.


RESULTS
The mean proportion of consultations in which GPs prescribed antibiotics was 33% (95% CI = 29 to 35%) of all RTIs. This proportion varied from 21% for patients with upper RTIs or an exacerbation of asthma/COPD, to about 70% when patients had sinusitis-like complaints or pneumonia. Amoxycillin and doxycycline were the most frequently prescribed antibiotics, while 17% of the antibiotics prescribed were macrolides. Multiple linear regression analysis showed that the longer GPs had practised, the more frequently they prescribed antibiotics, especially in combination with relatively little knowledge about RTIs or the less time GPs felt they had available per patient. The final model, with seven factors, explained 29% of the variance of antibiotic prescribing.


CONCLUSIONS
The prescribing behaviour of Dutch GPs might be improved with regard to choice of type and indication of antibiotics.
Akkerman
Annemiek E
AE
Julius Center for Health Sciences and Primary Care, Rotterdam, The Netherlands. A.Akkerman-2@umcutrecht.nl
Kuyvenhoven
Marijke M
MM
van der Wouden
Johannes C
JC
Verheij
Theo J M
TJ
D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000900:Anti-Bacterial Agents / Q000627:therapeutic use*; D002648:Child; D002675:Child, Preschool; D005194:Family Practice / Q000706:statistics & numerical data; D005260:Female; D006801:Humans; D007223:Infant; D007231:Infant, Newborn; D008297:Male; D008875:Middle Aged; D009426:Netherlands; D010818:Practice Patterns, Physicians'; D012141:Respiratory Tract Infections / Q000188:drug therapy*; D011795:Surveys and Questionnaires
D000900:Anti-Bacterial Agents
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