Antibiotic use in outpatients

Background: The study aim was to analyse the diagnostic and therapeutic app roach to selected infectious diseases, in particular with regard to the use of antibiotics, in the light of current guidelines and die problem of deve loping resistance. Methods: A questionnaire was sent to all physicians with a general or inter nal medicine practice in the Cantons Basel-Stadt and Basel-Landschaft, Swit zerland. Results: Of 440 physicians, 286 (65%) took part in the study. The most freq uent diagnoses of infection were cystitis (16.6%), flu-like syndrome (16.4% ), acute bronchitis (12.3%), and tonsillopharyngitis (10.1%). The most freq uent indications for antimicrobial therapy were cystitis (19.9%), acute sin usitis (14.1%), acute bronchitis (11.5%), and tonsillopharyngitis (9.2%). M acrolides (24.0%), aminopenicillins (22.6%), and fluoroquinolones (16.8%) w ere the most frequently prescribed antibiotics. Conclusions: The majority of physicians diagnosed and treated according to rational principles. However, a few exceptions were found, e.g. omission of x-ray in the diagnosis of pneumonia (24%), the use of antibiotics in the t reatment of viral diseases and antibiotic therapy for tonsillopharyngitis d espite a negative rapid antigen detection test against group A streptococci (75%).