Antibiotic prescription rate for upper respiratory tract infections and risks for unnecessary prescription in Croatia

Scientific paper - Original scientific paper

• Title (croatian): Stopa propisivanja antibiotika za infekcije gornjeg dišnog trakta i rizici za nepotrebno propisivanje antibiotika u Hrvatskoj
• Author: Marija Vrca Botica
• Author: Iva Botica
• Author: Valerija Stamenić
• Author: Arjana Tambić Andrašević
• Author: Josipa Kern
• Author: Stanislava Stojanović Špehar
• Author's institution: University of Zagreb; School of Medicine
• Scientific / art field, discipline and subdiscipline: BIOMEDICINE AND HEALTHCARE; Clinical Medical Sciences

Abstract (english)

Overprescribing of antibiotics in primary care has been recognized as public health problem. We investigated visits prescription rate of antibiotics to patients with upper respiratory tract infections (URTI) and unnecessary prescription for tonsillopharyngitis, in Croatia. In prospective observational study in November 2007. 25 GPs in Croatia recorded all patients' visits with URTI episode according ICPC-2. Clinical status of patients with tonsillopharyngitis were categorized according to Centor Criteria. 689 visits were analysed, 82% of visits were initial. Antibiotics were prescribed in 44.7% visits with URTI. There were no significant differences in antibiotic prescription rates regarding non-clinical factors. Antibiotics were prescribed to patients with tonsillopharyngitis in 62.2% visits. Unnecessary antibiotics were prescribed (Centor 1,2) in 49.6% visits with tonsillopharyngitis. Logistic regression analysis showed significant differences in unnecessary antibiotic prescription rates only with respect to the workday--Wednesday, CI (1.117-2.671), p = 0.0139. Leading antibiotic was amoxicillin + clavulonic acid, second was amoxicillin, the third were macrolides, the fourth was narrow spectrum penicillin and fifth were cephalosporins. This study shows over prescription for URTI. Unnecessary prescription for tonsillopharyngitis depend on non clinical factor--day of the week. This should be further explored and help to improved prescribe antibiotics.

Abstract (croatian)

Povećano propisivanje antibiotika u primarnoj zaštiti je prepoznato kao javno zdravstveni problem jer dovodi do
povećanja rezistencije na antibiotike. Istražili smo propisivanje antibiotika po posjetu liječniku opće medicine u tijeku
episode bolesti infekcija gornjeg respiratornog trakta (IGRT). Potom smo istražili nepotrebno propisivanje antibiotika
pacijentima s tanzilofaringitisom u općoj medicini u Hrvatskoj. Studija je bila prospektivna, a provedena je u studenom
2007. godine. 25 liječnika opće medicine bilježili su sve posjete pacijenata s epizodom bolesti – IGRT prema ICPC-2.
Klinički status pacijenata s epizodom tonzilofaringitisa određen je prema Centor Criteria klasifikaciji. Analizirano je
689 posjeta, od čega su 82% bili prvi posjeti. Antibiotici su propisani u 44,7% posjeta pacijentima sa IGRT. Nismo našli
statistički značajnu razliku u propisivanju antibiotika prema nekliničkim čimbenicima za pacijente s IGRT. Antibiotici
su propisani u 62,2% posjeta pacijentima sa tonzilofaringitisom. Za klinički status tonzilofaringitisa Centor 1 i 2, u
49,6% posjeta nepotrebno su propisani antibiotici. Logistička regresijska analiza pokazuje značajnost razlike za nepotrebno
propisivanje za dane u tjednu – srijeda, CI (1,117–2,671), p=0,0139. Od propisanih antibiotika na prvom je
mjestu amoksicilin + klavulonska kiselina, na drugom amoksicilin, na trećem mjestu su makrolidi, na četvrtom usko
spektralni penicilini, a na petomu cefalosporini. Studija pokazuje povećano propisivanje antibiotika za IGRT u Hrvatskoj.
Nepotrebno propisivanje za pacijente s tonzilofaringitisom ovisi o nekliničkim čimbenicima, dan u tjednu – srijeda.
Nalaz će se istražiti u sljedećim studijama s ciljem smanjenja propisivanja antibiotika u općoj medicini.

• Keywords (english): Adolescent; Adult; Aged; Anti-Bacterial Agents / therapeutic use; Child; Croatia / epidemiology; Drug Prescriptions / statistics & numerical data; Female; General Practice / statistics & numerical data; Humans; Male; Middle Aged; Practice Patterns, Physicians' / statistics & numerical data; Respiratory Tract Infections / drug therapy; Respiratory Tract Infections / epidemiology; Risk Factors; Unnecessary Procedures / statistics & numerical data; Young Adult
• Language: english
• Publication type: Scientific paper - Original scientific paper
• Publication status: Published
• Peer review: Peer review
• Publication version: Published version
• Journal title: Collegium Antropologicum
• Numbering: vol. 37, no. 2, pp. 449-454
• p-ISSN: 0350-6134
• URN:NBN: urn:nbn:hr:105:851145
• Publication: 2013-06
• Document URL: https://hrcak.srce.hr/104481
• Type of resource: Text
• Access conditions: Open access
• Created on: 2024-03-27 19:50:07