Deutsche medizinische Wochenschrift (1946) · 2010
[Differences in antibiotic prescribing between general practitioners and pediatricians in Hesse, Germany].
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Abbas S, Ihle P, Heymans L, Küpper-Nybelen J, Schubert I
Аннотация
BACKGROUND: A careful consideration of antibiotic prescription is necessary due to emerging antibiotic resistance. Differences in prescription rates between physician groups have only rarely been examined. We compared the prescription of antibiotics for systemic use in children between pediatricians and general practitioners (GPs).
METHOD: Data source was the statutory health insurance sample AOK Hesse/KV Hesse. Overall, 47,033 insured children in 2006 between 2 and 17 years of age were included in the analysis. Odds ratios (OR) and 95% confidence intervals (CI) for an antibiotic prescription were calculated by logistic regression adjusted for confounders, comparing pediatricians with GPs. Diagnosis-specific models were constructed.
RESULTS: GPs and pediatricians prescribed 79.3% of all antibiotics in 2006 (40.6% and 38.7%, respectively). Significantly decreased ORs for an antibiotic prescription were observed for pediatricians, with OR (95% CI) of 0.46 (0.43-0.49), 0.40 (0.30-0.54) and 0.40 (0.30-0.53) for respiratory tract infections, urinary tract infections and nonsuppurative otitis media, respectively. No significant associations were observed assessing scarlet fever, pneumonia and suppurative otitis media, respectively.
CONCLUSION: In this retrospective analysis, pediatricians were associated with a lower antibiotic prescription rate regarding diagnoses where antibiotic therapy is not clearly indicated. However, in diagnoses where antibiotic therapy is clearly indicated, no differences in prescription rates between pediatricians and GPs were observed. Further studies are warranted to gain insight into different treatment strategies between different groups of medical practitioners.
METHOD: Data source was the statutory health insurance sample AOK Hesse/KV Hesse. Overall, 47,033 insured children in 2006 between 2 and 17 years of age were included in the analysis. Odds ratios (OR) and 95% confidence intervals (CI) for an antibiotic prescription were calculated by logistic regression adjusted for confounders, comparing pediatricians with GPs. Diagnosis-specific models were constructed.
RESULTS: GPs and pediatricians prescribed 79.3% of all antibiotics in 2006 (40.6% and 38.7%, respectively). Significantly decreased ORs for an antibiotic prescription were observed for pediatricians, with OR (95% CI) of 0.46 (0.43-0.49), 0.40 (0.30-0.54) and 0.40 (0.30-0.53) for respiratory tract infections, urinary tract infections and nonsuppurative otitis media, respectively. No significant associations were observed assessing scarlet fever, pneumonia and suppurative otitis media, respectively.
CONCLUSION: In this retrospective analysis, pediatricians were associated with a lower antibiotic prescription rate regarding diagnoses where antibiotic therapy is not clearly indicated. However, in diagnoses where antibiotic therapy is clearly indicated, no differences in prescription rates between pediatricians and GPs were observed. Further studies are warranted to gain insight into different treatment strategies between different groups of medical practitioners.