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 infections with antibiotics in PHC.

DESIGN

A questionnaire study for general practitioners (GPs).

SETTING

All health centres of Pirkanmaa 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. Respiratory tract infections comprised 80% of all infections. Of all patients 64% received antimicrobial treatment. Unspecified upper respiratory tract infections and pharyngitis were rarely treated with antimicrobials (10 and 21%, respectively), whereas patients with acute bronchitis received antibiotics as often (83%) as patients with otitis media (93%) or tonsillitis (86%). The most commonly prescribed substances were cephalosporins (19% of all antimicrobials), penicillin V (17%), and amoxycillin (17%). Half of the cephalosporin use could be regarded as overuse. Half of the sulphatrimethoprims 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 antibiotics in primary health care.