Assessment of antibiotic prescribing in Latvian general practitioners

Abstract

BackgroundThough general antibiotic consumption data is available, information on the actual patterns of prescribing antibiotics locally is difficult to obtain. An easy to use methodology was designed to assess ambulatory management of infections by Latvian general practitioners (GPs).MethodsGPs were asked to record data in a patient data collection form for every patient that received antibiotics. Study period – (7 days) one week in November, 2008. Data recorded included the following details: an antibiotic, the prescribed dose, dosing interval, route of administration combined with the demographic factors of the patient and clinical diagnosis based on a pre-defined list.ResultsTwo hundred forty eight forms out of the 600 (41%) were returned by post. Antibiotics were prescribed in 6.4% (1711/26803) of outpatient consultations. In total, 1763 antibiotics were prescribed during the study period. Ninety seven percent of the patients received monotherapy and only 47 (2.7%) patients were prescribed two antibiotics. The most commonly prescribed antibiotics were amoxicillin (33.9% of prescribed), amoxicillin/clavulanate (18,7%) and clarithromycin (7.6%). The most commonly treated indications were pharyngitis (29.8%), acute bronchitis (25.3%) and rhinosinusitis (10.2%). Pneumonia was mostly treated with amoxicillin/clavulanate (25,7%), amoxicillin (15.7%) and clarithromycin (19.3%).ConclusionsMethodology employed provided useful additional information on ambulatory practice of prescribing antibiotics and could be used in further assessment studies. Educational interventions should be focused on treatment of acute pharyngitis and bronchitis in children and unnecessary use of quinolones in adults for uncomplicated urinary tract infection.

Consumption of oral antibiotic formulations for young children according to the WHO Access, Watch, Reserve (AWaRe) antibiotic groups: an analysis of sales data from 70 middle-income and high-income countries

“…2 Second, at least two-thirds and up to 90% of outpatient antibiotic prescriptions in young children are for respiratory tract infections (RTIs). 28,[35][36][37][38][39][40][41][42][43][44][45] These include upper RTIs, mainly otitis media and pharyngitis, in which antibiotic treatment may not necessarily be required in many cases. Equally, when antibiotics are prescribed, most international guidance suggests that narrow-spectrum options such as amoxicillin or phenoxymethylpenicillin should be used.…”

Evaluation of the Hungarian ambulatory antibacterial use in urinary tract infections with different methods

“…This finding is similar to findings of Spanish [252], French [192], and Latvian authors [257], who recorded fluoroquinolone use in 46.6 %, over 60%, and 41% of these cases, respectively.…”

“…Common ambulatory use of fluoroquinolones in treatment of UTIs has been reported from other European studies as well [192,257,252]. However low rate of fluoroquinolone use (6%) in this disease has been reported from Norway [189].…”

Surveillance of antibiotic use in the private sector in Namibia using sales and claims data

“…South Africa, which has a very similar health system to Namibia, has also been reported as having an increased use of broad-spectrum antibiotics [7,25]. This high use of broad-spectrum and newer antibiotics is a cause for concern since increased use of broad-spectrum antibiotics has been associated with the development of cross-resistance to other agents in the same class, compromising the use of the antibiotic class as a whole [20,21,26]. In this era where there are few antibiotics in development, the greatest concern with the development of resistance is that it could lead to a situation where healthcare professionals will not have appropriate medications to effectively treat infections [27][28][29][30].…”