tetano
Editor, Senior Moderator
Med J Aust. 2017 Jul 17;207(2):65-69.
[h=1]Antibiotics for acute respiratory infections in general practice: comparison of prescribing rates with guideline recommendations.[/h] McCullough AR[SUP]1[/SUP], Pollack AJ[SUP]2[/SUP], Plejdrup Hansen M[SUP]3[/SUP], Glasziou PP[SUP]4[/SUP], Looke DF[SUP]5[/SUP], Britt HC[SUP]6[/SUP], Del Mar CB.
[h=3]Author information[/h]
[h=3]Abstract[/h] [h=4]OBJECTIVE:[/h] To compare the current rate of antibiotic prescribing for acute respiratory infections (ARIs) in Australian general practice with the recommendations in the most widely consulted therapeutic guidelines in Australia (Therapeutic Guidelines).
[h=4]DESIGN AND SETTING:[/h] Comparison of general practice activity data for April 2010 - March 2015 (derived from Bettering the Evaluation and Care of Health [BEACH] study) with estimated rates of prescribing recommended by Therapeutic Guidelines.
[h=4]MAIN OUTCOME MEASURES:[/h] Antibiotic prescribing rates and estimated guideline-recommended rates per 100 encounters and per full-time equivalent (FTE) GP per year for eight ARIs; number of prescriptions nationally per year.
[h=4]RESULTS:[/h] An estimated mean 5.97 million (95% CI, 5.69-6.24 million) ARI cases per year were managed in Australian general practice with at least one antibiotic, equivalent to an estimated 230 cases per FTE GP/year (95% CI, 219-240 cases/FTE/year). Antibiotics are not recommended by the guidelines for acute bronchitis/bronchiolitis (current prescribing rate, 85%) or influenza (11%); they are always recommended for community-acquired pneumonia (current prescribing rate, 72%) and pertussis (71%); and they are recommended for 0.5-8% of cases of acute rhinosinusitis (current prescribing rate, 41%), 20-31% of cases of acute otitis media (89%), and 19-40% cases of acute pharyngitis or tonsillitis (94%). Had GPs adhered to the guidelines, they would have prescribed antibiotics for 0.65-1.36 million ARIs per year nationally, or at 11-23% of the current prescribing rate. Antibiotics were prescribed more frequently than recommended for acute rhinosinusitis, acute bronchitis/bronchiolitis, acute otitis media, and acute pharyngitis/tonsillitis.
[h=4]CONCLUSIONS:[/h] Antibiotics are prescribed for ARIs at rates 4-9 times as high as those recommended by Therapeutic Guidelines. Our data provide the basis for setting absolute targets for reducing antibiotic prescribing in Australian general practice.
[h=4]KEYWORDS:[/h] Anti-infective agents; Drug resistance, microbial; Prescribing; Primary care
PMID: 28701117
[h=1]Antibiotics for acute respiratory infections in general practice: comparison of prescribing rates with guideline recommendations.[/h] McCullough AR[SUP]1[/SUP], Pollack AJ[SUP]2[/SUP], Plejdrup Hansen M[SUP]3[/SUP], Glasziou PP[SUP]4[/SUP], Looke DF[SUP]5[/SUP], Britt HC[SUP]6[/SUP], Del Mar CB.
[h=3]Author information[/h]
[h=3]Abstract[/h] [h=4]OBJECTIVE:[/h] To compare the current rate of antibiotic prescribing for acute respiratory infections (ARIs) in Australian general practice with the recommendations in the most widely consulted therapeutic guidelines in Australia (Therapeutic Guidelines).
[h=4]DESIGN AND SETTING:[/h] Comparison of general practice activity data for April 2010 - March 2015 (derived from Bettering the Evaluation and Care of Health [BEACH] study) with estimated rates of prescribing recommended by Therapeutic Guidelines.
[h=4]MAIN OUTCOME MEASURES:[/h] Antibiotic prescribing rates and estimated guideline-recommended rates per 100 encounters and per full-time equivalent (FTE) GP per year for eight ARIs; number of prescriptions nationally per year.
[h=4]RESULTS:[/h] An estimated mean 5.97 million (95% CI, 5.69-6.24 million) ARI cases per year were managed in Australian general practice with at least one antibiotic, equivalent to an estimated 230 cases per FTE GP/year (95% CI, 219-240 cases/FTE/year). Antibiotics are not recommended by the guidelines for acute bronchitis/bronchiolitis (current prescribing rate, 85%) or influenza (11%); they are always recommended for community-acquired pneumonia (current prescribing rate, 72%) and pertussis (71%); and they are recommended for 0.5-8% of cases of acute rhinosinusitis (current prescribing rate, 41%), 20-31% of cases of acute otitis media (89%), and 19-40% cases of acute pharyngitis or tonsillitis (94%). Had GPs adhered to the guidelines, they would have prescribed antibiotics for 0.65-1.36 million ARIs per year nationally, or at 11-23% of the current prescribing rate. Antibiotics were prescribed more frequently than recommended for acute rhinosinusitis, acute bronchitis/bronchiolitis, acute otitis media, and acute pharyngitis/tonsillitis.
[h=4]CONCLUSIONS:[/h] Antibiotics are prescribed for ARIs at rates 4-9 times as high as those recommended by Therapeutic Guidelines. Our data provide the basis for setting absolute targets for reducing antibiotic prescribing in Australian general practice.
[h=4]KEYWORDS:[/h] Anti-infective agents; Drug resistance, microbial; Prescribing; Primary care
PMID: 28701117