A population-based study of different antibiotic prescribing in different areas.
BACKGROUND
Respiratory tract infections are the most common reason for antibiotic prescription in Sweden as in other countries. The prescription rates vary markedly in different countries, counties and municipalities. The reasons for these variations in prescription rate are not obvious.


OBJECTIVE
To find possible explanations for different antibiotic prescription rates in children.


METHODS
Prospective population based study.


METHODS
All child health clinics in four municipalities in Sweden which, according to official statistics, had high antibiotic prescription rates, and all child health clinics in three municipalities which had low antibiotic prescription rates.


METHODS
During one month, parents recorded all infectious symptoms, physician consultations and antibiotic treatments, from 848 18-month-old children in a log book. The parents also answered a questionnaire about socioeconomic factors and concern about infectious diseases.


RESULTS
Antibiotics were prescribed to 11.6% of the children in the high prescription area and 4.7% in the low prescription area during the study month (crude odds ratio [OR] = 2.67; 95% confidence interval [CI] = 1.45 to 4.93). After multiple logistic regression analyses taking account of socioeconomic factors, concern about infectious illness, number of symptom days and physician consultations, differences in antibiotic prescription rates remained (adjusted OR = 2.61; 95% CI = 1.14 to 5.98). The variable that impacted most on antibiotic prescription rates, although it was not relevant to the geographical differences, was a high level of concern about infectious illness in the family.


CONCLUSIONS
The differences in antibiotic prescription rates could not be explained by socioeconomic factors, concern about infectious illness, number of symptom days and physician consultations. The differences may be attributable to different prescription behaviour.
Hedin
Katarina
K
Unit of R&D, Kronoberg County Council, Växjö, Sweden. katarina.hedin@ltkronoberg.se
Andre
Malin
M
Håkansson
Anders
A
Mölstad
Sigvard
S
Rodhe
Nils
N
Petersson
Christer
C
D000900:Anti-Bacterial Agents / Q000627:therapeutic use*; D001291:Attitude of Health Personnel; D015331:Cohort Studies; D005194:Family Practice; D005260:Female; D005759:Gastroenteritis / Q000188:drug therapy*; D006801:Humans; D007223:Infant; D008297:Male; D008499:Medical Records; D010818:Practice Patterns, Physicians' / Q000706:statistics & numerical data*; D011446:Prospective Studies; D012141:Respiratory Tract Infections / Q000188:drug therapy*; D012959:Socioeconomic Factors; D013548:Sweden
D000900:Anti-Bacterial Agents