Tidsskrift for den Norske laegeforening : tidsskrift for praktisk medicin, ny raekke · 2011
[Do general practitioners follow the national guidelines for treating urinary tract infections with antibiotics?].
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Agdestein Benedicte, Lindbæk Morten, Gjelstad Svein
Аннотация
BACKGROUND: Incorrect use of antibiotics is a major public health concern both nationally and globally due to the development of antibiotic resistance. The goal of this study was to see if prescription of antibiotics for urinary tract infections in general practice was in accordance with national guidelines.
MATERIAL AND METHODS: We combined two sets of data from February and March 2003: prescriptions of antibiotics redeemed in pharmacies, and electronic billing cards collected from the National Insurance Agency from 145 general practitioners in Vestfold county. We analysed all consultations related to urinary tract problems, and we found which antibiotics had been prescribed and for how long. The treatment was then compared with the national guidelines. A logistic regression analysis identified factors associated with adequate treatment length.
RESULTS: Trimetoprime and mecillinam were most frequently prescribed to both genders. Sixty-nine (6 %) of the total 1,102 prescriptions were quinolones. A total of 271 (32 %) of 847 patients who were prescribed antibiotics for cystitis did not get treatment of sufficient length. Female and young patients were more often given the correct duration of treatment. Doctors with 1,000-1,500 patients more frequently prescribed sufficiently long treatment compared to other physicians. Six patients (0.5 %) were prescribed another antibiotic between two and 14 days after the first prescription.
CONCLUSION: The choice of antibiotics conformed well with national guidelines, but the duration of the treatment was often too short. In spite of this, only 0.5 % showed signs of relapse. A number of factors associated with adequate treatment length were identified. The empirical use of furadantin can be increased.
MATERIAL AND METHODS: We combined two sets of data from February and March 2003: prescriptions of antibiotics redeemed in pharmacies, and electronic billing cards collected from the National Insurance Agency from 145 general practitioners in Vestfold county. We analysed all consultations related to urinary tract problems, and we found which antibiotics had been prescribed and for how long. The treatment was then compared with the national guidelines. A logistic regression analysis identified factors associated with adequate treatment length.
RESULTS: Trimetoprime and mecillinam were most frequently prescribed to both genders. Sixty-nine (6 %) of the total 1,102 prescriptions were quinolones. A total of 271 (32 %) of 847 patients who were prescribed antibiotics for cystitis did not get treatment of sufficient length. Female and young patients were more often given the correct duration of treatment. Doctors with 1,000-1,500 patients more frequently prescribed sufficiently long treatment compared to other physicians. Six patients (0.5 %) were prescribed another antibiotic between two and 14 days after the first prescription.
CONCLUSION: The choice of antibiotics conformed well with national guidelines, but the duration of the treatment was often too short. In spite of this, only 0.5 % showed signs of relapse. A number of factors associated with adequate treatment length were identified. The empirical use of furadantin can be increased.