How often do general practitioners prescribe antibiotics for otitis media and the most common respiratory tract infections?

Abstract

Objective: To examine how frequently general practitioners actually prescribe antibiotics for patients contacting them for otitis media, and the most common respiratory tract infection diagnoses, -by the type of doctor-patient contact during prescribing, and patients' age and sex. Design: Cross sectional, multipractice study. Setting: GPs in the Norwegian county of Møre & Romsdal. Data were recorded during two months. Material: 8610 physician-patient contacts, and 4909 antibiotic prescriptions for otitis media, upper respiratory tract infection, tonsillitis, sinusitis, acute bronchitis, and pneumonia. Results: Antibiotics were issued during 57% of all contacts for the included diagnoses, ranging from 22% (upper respiratory tract infection) to 91% (tonsillitis). All patients who had first time office consultations for tonsillitis, acute bronchitis and pneumonia, were prescribed antibiotics. One out of three patients who consulted the doctor on the telephone for these diagnoses, were also prescribed an antibiotic. Conclusion: Except for upper respiratory tract infection, antibiotic treatment is the rule not an exception, for all the diagnoses studied. In general practice, improved communication-and prescribing-skills are probably essentials for implementing a more evidence based treatment of otitis media, and the common respiratory tract infections. The significance of patient related factors for seeing a GP (or not) and for (not) expecting antibiotics for otitis media and the common respiratory tract infections should be explored in future research.