Determinants of prescribing of second-choice antibiotics for upper and lower respiratory tract episodes in Dutch general practice.
OBJECTIVE
The aim of this study was to assess the association between general practitioners' (GPs') characteristics and the volume of second-choice antibiotics for acute respiratory tract (RT) episodes by GPs.


METHODS
Morbidity and antibiotic prescription data originated from the Second Dutch National Survey of General Practice (DNSGP-2). GPs' characteristics, including professional activities and views on RT symptoms and antibiotics, were measured by a written questionnaire. Multiple regression was carried out to assess associations between possible determinants and volume of second-choice antibiotic prescriptions.


RESULTS
In approximately 39% of acute RT episodes antibiotics were prescribed, with one-quarter being second-choice antibiotics, relatively more frequently in lower than in upper RT episodes: 30 versus 19%. GPs who were more frequently consulted by patients with RT episodes (beta = 0.29; 95% CI 0.13-0.41), who labelled RT episodes more as diagnoses than as symptoms (beta = 0.27; 95% CI 0.15-0.42), who less frequently used national GP guidelines (beta = -0.17; 95% CI -0.31 to -0.03) and who were more inclined to prescribe new drugs (beta = 0.26; 95% CI 0.13-0.40), prescribed more second-choice antibiotics.


CONCLUSIONS
Given the growing number of prescriptions of second-choice antibiotics, it is important to implement professional guidelines in daily practice, while training in being reluctant to prescribe new drugs and being alert to the marketing activities of pharmaceutical companies should be started in the medical curriculum.
van Duijn
Huug J
HJ
Julius Center for Health Sciences and Primary Care, University Medical Center (UMC), Str. 6.131, PO Box 85060, 3508 AB Utrecht. hj@vduijn.nl
Kuyvenhoven
Marijke M
MM
Schellevis
François G
FG
Verheij
Theo J M
TJ
D000900:Anti-Bacterial Agents / Q000627:therapeutic use*; D011307:Drug Prescriptions / Q000706:statistics & numerical data*; D004363:Drug Utilization; D005260:Female; D006801:Humans; 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