title: [Change in attitude towards antibiotic prescriptions among Icelandic general practitioners].
abstract: BACKGROUND
  Antibiotic use is a leading cause of antibiotic resistance and it is therefore important to reduce unnecessary prescribing in Iceland where antibiotic use is relatively high. The purpose of this study was to explore antibiotic prescribing practices among Icelandic physicians and compare the results with results of comparable studies from 1991 and 1995 conducted by the Directorate of Health, Iceland.
  
  
  METHODS
  A descriptive cross-sectional study was carried out among all general practitioners registered in Iceland in 1991 and 1995 and all physicians registered in March 2014. Data was collected with questionnaires regarding diagnosis and treatment of simple urinary tract infection, acute otitis media and pharyngitis. A multiple logistic regression analysis was performed and level of significance p≤0.05.
  
  
  RESULTS
  Response rates were 85% and 93% in 1991 and 1995 but 31% in 2014. Proportion of physicians who consider themselves prescribing antibiotics more than 10 times per week was 36% in 1991, 32% in 1995 and 21% in 2014. Proportion of trimethoprim-sulfamethoxazole as first choice for simple urinary tract infection reduced from 43% and 45% to 8% in 2014. In 2014, general practitioners considered themselves 87% less likely to prescribe an antibiotic for acute otitis media than in 1991 (p<0.001). They also claimed to use rapid diagnostic tests in pharyngitis five times more often in 2014 than in 1991 (p<0.001).
  
  
  CONCLUSIONS
  Antibiotic prescribing practices have changed significantly in the past two decades in Iceland becoming more in line with clinical guidelines. Improvements are still needed to further reduce inappropriate antibiotic use.
authors.forename: Anna Mjöll
authors.initials: AM
authors.lastname: Matthíasdóttir
authors.forename: Thórólfur
authors.initials: T
authors.lastname: Guðnason
authors.forename: Matthías
authors.initials: M
authors.lastname: Halldórsson
authors.forename: Ásgeir
authors.initials: Á
authors.lastname: Haraldsson
authors.forename: Karl G
authors.initials: KG
authors.lastname: Kristinsson
mesh_terms: D000900:Anti-Bacterial Agents / Q000627:therapeutic use*; D001291:Attitude of Health Personnel; D001424:Bacterial Infections / Q000175:diagnosis / Q000188:drug therapy* / Q000382:microbiology; D001431:Bacteriological Techniques; D003430:Cross-Sectional Studies; D011307:Drug Prescriptions; D024881:Drug Resistance, Bacterial; D058005:General Practitioners / Q000523:psychology*; D019983:Guideline Adherence; D019538:Health Care Surveys; D007722:Health Knowledge, Attitudes, Practice; D006801:Humans; D007055:Iceland; D057970:Inappropriate Prescribing; D016015:Logistic Models; D000069342:Medical Overuse; D015999:Multivariate Analysis; D017410:Practice Guidelines as Topic; D010818:Practice Patterns, Physicians' / Q000639:trends; D011237:Predictive Value of Tests; D011795:Surveys and Questionnaires; D013997:Time Factors
chemical_list: D000900:Anti-Bacterial Agents