Indication-based use of antimicrobials in Finnish primary health care - Description of a method for data collection and results of its application

Objective-To collect population-based information on treatment of infection s with antibiotics in PHC. Design-A questionnaire study for general practit ioners (GPs). Setting-All health centres of Pirkamnaa Hospital District in Finland. Patients-Patients with any infection attending health centre during 1 week in November 1994. Main outcome measures-An infection diagnosis by the GP. Results-A total of 4150 questionnaires were received from 223 doctors. Resp iratory tract infections comprised 80% of all infections. Of all patients 6 4% received antimicrobial treatment. Unspecified upper respiratory tract in fections and pharyngitis were rarely treated with antimicrobials (10 and 21 %, respectively), whereas patients with acute bronchitis received antibioti cs as often (83%) as patients with otitis media (93%) or tonsillitis (86%). The most commonly prescribed substances were cephalosporins (19% of all an timicrobials), penicillin V (17%), and amoxycillin (17%). Half of the cepha losporin use could be regarded as overuse. Half of the sulphahrimethoprims were used for otitis media. A quarter of the patients expressed a desire to receive antibiotic treatment. Conclusion-The method was practical, inexpensive, and successful in giving such information, which is needed for supervising the rational use of antib iotics in primary health care.