Appropriateness of antibiotic prescribing for upper respiratory tract infections in general practice: Comparison between Denmark and Iceland

TY - JOUR

T1 - Appropriateness of antibiotic prescribing for upper respiratory tract infections in general practice

T2 - Comparison between Denmark and Iceland

AU - Sigurðardóttir, Nanna Rún

AU - Nielsen, Anni Brit Sternhagen

AU - Munck, Anders

AU - Bjerrum, Lars

PY - 2015/10/2

Y1 - 2015/10/2

N2 - Objective: To compare the appropriateness of antibiotic prescribing for upper respiratory tract infections (URTIs) in two countries with different prevalence of antimicrobial resistance: Denmark and Iceland.Design: A cross-sectional study. Settings and subjects. General practitioners (GPs) in Denmark (n = 78) and Iceland (n = 21) registered all patients with URTI according to the Audit Project Odense (APO) method during a three-week period in the winter months of 2008 and 2009.Main outcome measures: Appropriateness of antibiotic prescribing in patients with URTI in Denmark and Iceland.Results: A total of 1428 patients were registered (Denmark: n = 1208; Iceland: n = 220). A majority of patients in both countries were prescribed antibiotics, and only a minority of the prescriptions could be classified as appropriate prescribing. In general, Icelandic GPs more often prescribed antibiotics (Iceland = 75.8% vs. Denmark = 59.3%), but Danish GPs had a higher percentage of inappropriate antibiotic prescribing for sinusitis, and Icelandic GPs for pharyngotonsillitis. No differences were found for acute otitis media (AOM). The different antibiotic prescribing patterns between Denmark and Iceland could not fully be explained by different symptoms and signs among patients.Conclusion: Icelandic GPs have a higher antibiotic prescribing rate compared with Danish GPs, but the percentage of inappropriate antibiotic prescribing is highest in Denmark for sinusitis, and in Iceland for pharyngotonsillitis.Key pointsWithin the Nordic countries there are marked differences in antimicrobial resistance and antibiotic use.Iceland differs from Denmark by a higher antibiotic prescribing rate and a higher prevalence of antimicrobial resistance.The majority of antibiotics are prescribed in primary care and most often for upper respiratory infections (URTIs).Only a minor amount of antibiotic prescriptions for URTIs can be classified as appropriate; inappropriate antibiotic prescribing is higher in Denmark than in Iceland for sinusitis and the opposite for pharyngotonsillitis.The different antibiotic prescribing patterns between Denmark and Iceland cannot be fully explained by different clinical criteria among patients.

AB - Objective: To compare the appropriateness of antibiotic prescribing for upper respiratory tract infections (URTIs) in two countries with different prevalence of antimicrobial resistance: Denmark and Iceland.Design: A cross-sectional study. Settings and subjects. General practitioners (GPs) in Denmark (n = 78) and Iceland (n = 21) registered all patients with URTI according to the Audit Project Odense (APO) method during a three-week period in the winter months of 2008 and 2009.Main outcome measures: Appropriateness of antibiotic prescribing in patients with URTI in Denmark and Iceland.Results: A total of 1428 patients were registered (Denmark: n = 1208; Iceland: n = 220). A majority of patients in both countries were prescribed antibiotics, and only a minority of the prescriptions could be classified as appropriate prescribing. In general, Icelandic GPs more often prescribed antibiotics (Iceland = 75.8% vs. Denmark = 59.3%), but Danish GPs had a higher percentage of inappropriate antibiotic prescribing for sinusitis, and Icelandic GPs for pharyngotonsillitis. No differences were found for acute otitis media (AOM). The different antibiotic prescribing patterns between Denmark and Iceland could not fully be explained by different symptoms and signs among patients.Conclusion: Icelandic GPs have a higher antibiotic prescribing rate compared with Danish GPs, but the percentage of inappropriate antibiotic prescribing is highest in Denmark for sinusitis, and in Iceland for pharyngotonsillitis.Key pointsWithin the Nordic countries there are marked differences in antimicrobial resistance and antibiotic use.Iceland differs from Denmark by a higher antibiotic prescribing rate and a higher prevalence of antimicrobial resistance.The majority of antibiotics are prescribed in primary care and most often for upper respiratory infections (URTIs).Only a minor amount of antibiotic prescriptions for URTIs can be classified as appropriate; inappropriate antibiotic prescribing is higher in Denmark than in Iceland for sinusitis and the opposite for pharyngotonsillitis.The different antibiotic prescribing patterns between Denmark and Iceland cannot be fully explained by different clinical criteria among patients.

KW - Faculty of Health and Medical Sciences

KW - General Practice

KW - Upper respiratory tract infections

KW - Antibiotics

KW - Diagnostic criteria

KW - Iceland

KW - Denmark

KW - Antibiotics

KW - Denmark

KW - Diagnostic criteria

KW - General practice

KW - Upper respiratory tract infections

U2 - 10.3109/02813432.2015.1114349

DO - 10.3109/02813432.2015.1114349

M3 - Journal article

C2 - 26683287

SN - 0281-3432

VL - 33

SP - 269

EP - 274

JO - Scandinavian Journal of Primary Health Care

JF - Scandinavian Journal of Primary Health Care

IS - 4

ER -