THE QUALITY OF ANTIBIOTIC-TREATMENT IN PR IMARY HEALTH-CARE IN THE COUNTY OF OSONA (BARCELONA, SPAIN)

BACKGROUND: The evaluation and quality control of antibiotic prescript ion has become widespread in primary health care (PHC). Most of the st udies performed have analyzed the quality of the drug and not the trea tment. The aim of this study was to evaluate the quality of the antibi otic treatments of physicians in a concrete area and identify the most deficient aspects. METHODS: A prospective study was performed with th e voluntary participation of general physicians and pediatricians of t he PHC area of Osona (Barcelona, Spain) by the collection of a series of data of each antibiotic treatment carried out over 30 days. Conside ration of each item to evaluate the quality of a given treatment was c arried out by a nominal group. RESULTS: A total of 1,976 antibiotic tr eatments were administered by the 44 physicians participating in the s tudy (68% of the target population). The aspect found to be most defic ient was that 20% of the doctors prescribed an antibiotic in a diagnos is for which it was not susceptible and in 30% of the susceptible case s the choice of antibiotic was erroneous. The length of treatment was the aspect on posology showing the worst results (27% incorrect). The mean quality following the application of the scale elaborated by the nominal group was 72.6 (SD = 25.7) over a maximum of 100. Lower qualit y was observed in the pediatricians (p = 0.006), in the phsycians work ing in the reformed network (p < 0.0001), in the prescriptions induced by another physician (p = 0.0001) and in those induced by the patient (p = 0.03). CONCLUSIONS: The number of antibiotics prescribed in non susceptible processes in primary health care should be reduced. Likewi se, the choice of antibiotics prescribed should improve.