Antibiotic prescriptions to adults with acute respiratory tract infections by Italian general practitioners
Antibiotic prescriptions to adults with acute respiratory tract infections by Italian general practitioners
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DOI：
10.2147/idr.s170349
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发表时间：
2018-01-01
影响因子：
3.9
通讯作者：
Pavia, Maria
中科院分区：
文献类型：
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作者：
Bianco, Aida;Papadopoli, Rosa;Pavia, Maria
目的：抗菌药物的过度使用、误用和使用不足往往导致耐药微生物的传播。我们的研究的目的是描述的模式抗生素处方急性呼吸道感染（RTIs）的成人人群和相关因素与抗生素prescription.Patients和方法：这项研究涉及的患者谁访问了全科医生怀疑急性RTI。诊断为急性鼻窦炎、急性咽炎、急性支气管炎和流感的患者纳入研究。我们根据国际指南评估了选定疾病的抗生素治疗适应症的存在。结果：总共有1，979例急性呼吸道感染包括：1，196例（60.4%）咽炎，359例（18.2%）支气管炎，234例（11.8%）流感，190例（9.6%）鼻窦炎。抗生素处方在67.3%的咨询，并没有指出的指南在66.5%的总RTI。大环内酯类是最常使用的抗生素，占所有处方的32.5%，其次是阿莫西林和克拉维酸（31.1%）和氟喹诺酮类（14.2%）。最高的过度处方与咽炎（65.9%）有关，最低的与流感（4.9%）有关。咽拭子进行了所有的患者中只有11个诊断为急性咽炎。结论：本研究显示了一个非常高的频率，非循证处方的抗生素在初级保健水平。未来的改进计划应侧重于制定循证指南，获得研究生培训，以及更好地提供诊断工具。
Purpose: The overuse, misuse, and underuse of antimicrobial agents often lead to the spread of antibiotic-resistant microorganisms. The aim of our study was to describe the pattern of antibiotic prescriptions for acute respiratory tract infections (RTIs) among the adult population and the factors associated with antibiotic prescribing.Patients and methods: The study involved patients who visited a general practitioner with suspected acute RTI. Patients with diagnosis of acute sinusitis, acute pharyngitis, acute bronchitis, and influenza were included in the study. We evaluated the presence of an indication for antibiotic therapy for selected diseases according to international guidelines. The appropriateness of any prescribed molecule was also evaluated.Results: A total of 1,979 cases of acute RTIs were included: 1,196 (60.4%) pharyngitis, 359 (18.2%) bronchitis, 234 (11.8%) influenza, and 190 (9.6%) sinusitis. An antibiotic prescription was given in 67.3% of the consultations and was not indicated by the guidelines in 66.5% of the total RTIs. Macrolides were the most frequently prescribed antibiotics accounting for 32.5% of all those prescribed, followed by amoxicillin with clavulanic acid (31.1%) and fluoroquinolones (14.2%). The highest overprescription was associated with pharyngitis (65.9%) and the lowest with influenza (4.9%). A throat swab was performed only in 11 of all the patients with a diagnosis of acute pharyngitis.Conclusion: The present study showed a very high frequency of nonevidence-based prescription of antibiotics at the primary care level. Future improvement programs should focus on development of evidence-based guidelines, access to postgraduate training, and better availability of diagnostic tools.