title: Quality of antibiotic prescription during office hours and out-of-hours in Flemish primary care, using European quality indicators.
abstract: BACKGROUND
  European disease-specific antibiotic prescribing quality indicators (APQI) were proposed for seven acute indications (bronchitis, upper respiratory infection, cystitis, tonsillitis, sinusitis, otitis media and pneumonia): (a) the percentage of patients prescribed an antibiotic; (b) the percentage of patients receiving the guideline recommended antibiotic; (c) the percentage of patients receiving quinolones.
  
  
  OBJECTIVE
  To assess the feasibility of calculating values for these 21 APQI using primary care databases; and to assess the quality of antibiotic prescribing in office hours and out-of-hours general practice.
  
  
  METHODS
  Data was extracted from a morbidity registration network ( http://www.intego.be ) and the out-of-hours service centre in Flanders. Within both databases diagnoses are labelled using the revised second edition of International Classification of Primary Care (ICPC-2-R) and antibiotic prescriptions using Anatomical Therapeutic Chemical (ATC) classification.
  
  
  RESULTS
  Both databases allow calculation of APQI values and results are similar. Only for cystitis was the percentage of patients prescribed an antibiotic within the proposed acceptable range. For all indications, the percentage of recommended antibiotics was below the proposed acceptable range (80-100%). The percentage of quinolones was within the proposed acceptable range (0-5%) for otitis media, upper respiratory infection and tonsillitis.
  
  
  CONCLUSIONS
  Primary care databases can produce APQI values. These values revealed huge opportunities to improve the quality of antibiotic prescribing in office hours and out-of-hours Flemish general practice, especially the prescription of recommended antibiotics.
authors.affiliation: University of Antwerp, Vaccine & Infectious Disease Institute (VAXINFECTIO), Centre for General Practice , Antwerp , Belgium.
authors.forename: Niels
authors.initials: N
authors.lastname: Adriaenssens
authors.forename: Stefaan
authors.initials: S
authors.lastname: Bartholomeeusen
authors.forename: Philippe
authors.initials: P
authors.lastname: Ryckebosch
authors.forename: Samuel
authors.initials: S
authors.lastname: Coenen
mesh_terms: D000293:Adolescent; D000328:Adult; D039602:After-Hours Care / Q000592:standards*; D000368:Aged; D000900:Anti-Bacterial Agents / Q000627:therapeutic use*; D001991:Bronchitis / Q000188:drug therapy; D002648:Child; D002675:Child, Preschool; D003556:Cystitis / Q000188:drug therapy; D016208:Databases, Factual; D011307:Drug Prescriptions / Q000592:standards*; D005260:Female; D019983:Guideline Adherence; D006801:Humans; D007223:Infant; D008875:Middle Aged; D009426:Netherlands; D010033:Otitis Media / Q000188:drug therapy; D018410:Pneumonia, Bacterial / Q000188:drug therapy; D017410:Practice Guidelines as Topic; D011320:Primary Health Care / Q000592:standards*; D019984:Quality Indicators, Health Care; D015363:Quinolones / Q000627:therapeutic use; D012852:Sinusitis / Q000188:drug therapy; D014069:Tonsillitis / Q000188:drug therapy; D055815:Young Adult
chemical_list: D000900:Anti-Bacterial Agents; D015363:Quinolones
keywords: antibacterials; drug therapy; evidence-based medicine; primary care; quality of care