Prescribing habits of general practitioners in choosing an empirical antibiotic regimen for lower respiratory tract infections in adults in Sicily

The survey was carried out, between September 1995 and May 1996, in order t o describe the prescriptive behaviour among Sicilian general practitioners (GPs) in choosing an empirical antibiotic regimen for LRTIs in adult patien ts and begin an educational process which involves the same GPs in decision s regarding their prescriptions and in performing local guidelines. Each pr actitioner filled out a questionnaire for each therapeutic intervention whi ch ended with an antibiotic prescription. The questionnaire also enquired i nto the patient's characteristics, diseases to the treated and drug prescri ption. Doctors were asked to give an opinion about the severity assessment of the infectious disease before choosing the antibiotic treatment, in orde r to evaluate the prescriptive behaviour of physicians related to the patie nt's symptoms. Of all Sicilian GPs approached, 76 physicians from 25 Sicili an towns, with a patient population of 96,630, agreed to participate. The G Ps used 49 different molecules and six different associations of two antibi otics. The most frequently used antibacterial agents were cephalosporins (5 5.0%). Penicillins (11.7%), fluoroquinolones (11.4%), macrolides (10.1%) an d combinations of penicillins with beta-lactamase inhibitors (7.9%), togeth er, represented 41.1% of the remaining antibiotic prescriptions. The choice of the route of administration was significantly influenced by age of the patients, by symptoms and signs of the disease and by the presence of concu rrent diseases rather than by bacteria suspected of causing the disease. Th e rather marked variation in antibiotic prescribing pattern for LRTIs among Sicilian GPs reflects lack of availability or knowledge of any local or na tional guidelines about the management of these diseases. (C) 1999 Academic Press.