GPs' antibiotic prescription patterns for respiratory tract infections--still room for improvement.
OBJECTIVE
Inappropriate use of antibiotics is associated with increased antibiotic resistance in the community. About 90% of all antibiotic prescriptions in Norway are issued by general practitioners and in 60% issued for respiratory tract infections. The article describes and analyses antibiotic prescription patterns by general practitioners in Vestfold, Norway.


METHODS
Prospective cohort study.


METHODS
A total of 145 list-holding general practitioners in Vestfold, Norway in February to March 2003.


METHODS
Merging of two electronic administrative data sets: antibiotic prescriptions dispensed in pharmacies and general practitioners' electronic bills from the National Insurance Agency.


METHODS
Proportion and type of antibiotic prescribed for different respiratory tract infectious diagnoses.


RESULTS
We found large variations among general practitioners' antibiotic prescription habits. In 27% of consultations with RTI diagnoses, an antibiotic was prescribed; 37% were for Penicillin V and 28% for a macrolide. Quinolones and cephalosporins were only rarely prescribed. In a logistic regression analysis the following factors were independently associated with antibiotic prescription rate: type of infection, type of contact, being a general practitioner specialist, and years since medical exam. In another logistic regression analysis the following factors were independently associated with broad-spectrum antibiotic prescription: type of infection, age of patient, type of contact, being a specialist, length of list, and being a high prescriber of antibiotics.


CONCLUSIONS
The variation in proportion of total antibiotic prescribing and broad-spectrum prescription for respiratory tract infections is high, and reveals potentials to change general practitioners' prescription behaviour, in order to maintain the positive situation in Norway as to antibiotic resistance.
Gjelstad
Svein
S
Department of General Practice and Community Medicine, Antibiotic Centre for Primary Care, University of Oslo, Norway.
Dalen
Ingvild
I
Lindbaek
Morten
M
D000328:Adult; D000900:Anti-Bacterial Agents / Q000008:administration & dosage* / Q000009:adverse effects; D002648:Child; D015331:Cohort Studies; D011307:Drug Prescriptions / Q000706:statistics & numerical data*; D024881:Drug Resistance, Bacterial; D005194:Family Practice; D019983:Guideline Adherence; D006801:Humans; D018942:Macrolides / Q000008:administration & dosage; D010404:Penicillin V / Q000008:administration & dosage; D010818:Practice Patterns, Physicians'; D011446:Prospective Studies; D012141:Respiratory Tract Infections / Q000175:diagnosis / Q000188:drug therapy*
D000900:Anti-Bacterial Agents; D018942:Macrolides; D010404:Penicillin V