title: Inappropriate antibiotic prescribing and demand for antibiotics in patients with upper respiratory tract infections is hardly different in female versus male patients as seen in primary care.
abstract: BACKGROUND
  Unnecessary prescribing of antibiotics is a major public health concern. General practitioners (GPs) prescribe most antibiotics, often for upper respiratory tract infections (URTIs), and have in general been shown to prescribe antibiotics more often to women. No studies have examined the influence of patient gender on unnecessary antibiotic prescribing.
  
  
  OBJECTIVE
  To study a possible gender difference in unnecessary antibiotic prescriptions for URTIs in general practice; to assess whether a possible difference is explained by patient demand for antibiotics.
  
  
  METHODS
  Post-hoc analysis of a cross-sectional study including 15,022 patients with URTI (acute rhinitis, acute otitis media, acute sinusitis, acute pharyngotonsillitis) from Argentina, Denmark, Lithuania, Russia, Spain and Sweden (HAPPY AUDIT Project). The association between gender and unnecessary antibiotic prescriptions, unadjusted and adjusted for treatment demand, was analysed using logistic regression models.
  
  
  RESULTS
  A total of 25% of patients with URTI received antibiotics; in 45% of the cases, antibiotics were unnecessary. Overall, no gender difference for unnecessary prescribing of antibiotics for URTIs was found. Women with acute otitis media received an unnecessary antibiotic twice as often as men (14.4% versus 7.1%). In Danish patients with acute pharyngotonsillitis, there was a gender difference in unnecessary prescriptions for antibiotics (women 29.1% versus men 48.6%). Some 14% of patients receiving unnecessary antibiotics demonstrated a demand for antibiotics, but no gender difference was found in this group.
  
  
  CONCLUSIONS
  This study indicated a high rate of unnecessary antibiotic prescribing for URTIs in general practice, but overall found no gender differences in receiving unnecessary antibiotic prescriptions.
authors.affiliation: Section and Research Unit of General Practice, Department of Public Health, University of Copenhagen , Denmark.
authors.forename: Kathrine
authors.initials: K
authors.lastname: Bagger
authors.forename: Anni B Sternhagen
authors.initials: AB
authors.lastname: Nielsen
authors.forename: Volkert
authors.initials: V
authors.lastname: Siersma
authors.forename: Lars
authors.initials: L
authors.lastname: Bjerrum
mesh_terms: D000900:Anti-Bacterial Agents / Q000627:therapeutic use*; D001118:Argentina; D003430:Cross-Sectional Studies; D003718:Denmark; D005260:Female; D006801:Humans; D057970:Inappropriate Prescribing / Q000706:statistics & numerical data*; D008097:Lithuania; D008297:Male; D010033:Otitis Media / Q000188:drug therapy; D010342:Patient Acceptance of Health Care / Q000706:statistics & numerical data*; D010612:Pharyngitis / Q000188:drug therapy; D011320:Primary Health Care / Q000706:statistics & numerical data*; D012141:Respiratory Tract Infections / Q000188:drug therapy*; D012426:Russia; D012737:Sex Factors; D013030:Spain; D013548:Sweden; D014069:Tonsillitis / Q000188:drug therapy
chemical_list: D000900:Anti-Bacterial Agents
keywords: General practice; antibiotics; gender; infectious diseases; upper respiratory tract