PRESCRIBING SYSTEMIC ANTIBIOTICS IN GENERAL-PRACTICE - A REPORT FROM THE MORE-AND-ROMSDAL PRESCRIPTION STUDY

Objective - To describe general practitioners' (GPs) prescribing patte rns for antibiotics and to compare them with therapeutic guidelines. D esign - Cross-sectional, observational study. Setting-In the Norwegian county More & Romsdal the GPs recorded aid contacts with patients and prescriptions during two months. Subjects - 69843 contacts with 56758 prescriptions, of which 7905 were for systemic antibiotics. Main outc ome measures - Prescriptions in relation to diagnosis, kind of consult ation, and patients' age and sex. Results - 61% of all antibiotic pres criptions were for females, 26% were issued during indirect contacts, and 14% were repeat prescriptions. Phenoxymethylpenicillin was prescri bed most frequently (32%), followed by co-trimoxazole (19%), tetracycl ines (18%), erythromycin (16%), and penicillins with extended spectrum (6%). Urinary tract infection was the most frequent diagnosis for ant ibiotic prescribing (24%), followed by acute bronchitis (13%), ear inf ections (9%), upper respiratory tract infections (8%), and acute tonsi llitis (8.2%). A regression analysis showed that first-time consultati ons for tonsillitis and otitis, but not for acute bronchitis and pneum onia, patient age 13-64 years, female physician, urban practice locati on, and a fixed GP salary were associated with the prescribing of phen oxymethylpenicillin in contrast to other antibiotics. Conclusion - Ant ibiotics are often prescribed for viral infections (e.g. acute bronchi tis). Broad spectrum antibiotics are often prescribed for diagnoses wh ere penicillin is recommended as first choice. The issue of antibiotic misuse should be addressed more explicitly in general practice.