Trends in number of consultations and antibiotic prescriptions for respiratory tract infections between 1999 and 2005 in primary healthcare in Kalmar County, Southern Sweden
Trends in number of consultations and antibiotic prescriptions for respiratory tract infections between 1999 and 2005 in primary healthcare in Kalmar County, Southern Sweden
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DOI：
10.1080/02813430802610784
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发表时间：
2009-01-01
影响因子：
2.1
通讯作者：
Molstad, Sigvard
中科院分区：
文献类型：
--
作者：
Neumark, Thomas;Brudin, Lars;Molstad, Sigvard
背景呼吸道感染（RTI）是咨询全科医生并获得抗生素处方的最常见适应症。Objective.研究1999-2005年期间在初级保健中RTI的就诊、诊断和抗生素处方数量的变化。设计电子病历的回顾性、描述性、基于人群的研究。设置.瑞典东南部卡尔马县。患者1999年7月1日至2005年12月31日期间，因呼吸道感染到卡尔马县初级保健单位就诊的患者。主要结果指标。呼吸道感染诊断，抗生素处方，年龄组。结果1999年至2005年期间，共对240 447次RTI访问进行了分析。诊断急性扁桃体炎和AOM的年咨询率分别下降了12%和10%（p = 0.001）。在所有咨询RTI诊断的患者中，45%接受了抗生素治疗。在所有处方抗生素中，60%为苯氧甲基青霉素（PcV），18%为强力霉素。处方阿莫西林或阿莫西林+克拉维酸的程度较低。随着时间的推移，获得抗生素处方的患者比例几乎保持不变（44-46%）。多西环素类药物处方用药量呈上升趋势（NS）。剩余抗生素的处方显著减少，尤其是中年患者。结论这项大规模人群研究，包括超过六年的观察，显示在1999-2005年期间，接受RTI诊断的初级保健患者数量减少，但接受抗生素处方的患者比例保持不变。大的季节性变化表明需要进一步干预，以减少抗生素用于RTI。
Background. Respiratory tract infections (RTIs) comprise the most common indication for consulting a general practitioner and obtaining an antibiotic prescription. Objective. To study changes in the number of visits, diagnoses, and antibiotic prescriptions for RTI in primary healthcare during the period 1999-2005. Design. A retrospective, descriptive, population-based study of electronic patient records. Setting. County of Kalmar in southeastern Sweden. Patients. Patients visiting primary healthcare units in Kalmar County for an RTI between 1 July 1999 and 31 December 2005. Main outcome measures. RTI diagnoses, antibiotic prescriptions, age groups. Results. A total of 240 447 visits for RTI made between 1999 and 2005 were analysed. The yearly consultation rates for the diagnoses acute tonsillitis and AOM decreased by 12% and 10%, respectively (p = 0.001). Of all patients consulting for an RTI diagnosis, 45% received antibiotics. Of all prescribed antibiotics, 60% were for phenoxymethylpenicillin (PcV) and 18% doxycycline. Amoxicillin or amoxicillin + clavulanic acid was prescribed to a lesser extent. The proportion of patients obtaining an antibiotic prescription was almost constant over time (44-46%). The prescriptions of doxycycline showed increasing values (NS). The prescriptions of remaining antibiotics decreased significantly especially for patients up to middle age. Conclusion. This large population study, comprising more than six years of observations, showed the number of primary healthcare patients receiving an RTI diagnosis decreased during the period 1999-2005, but the proportion of patients receiving an antibiotic prescription remained the same. The large seasonal variations indicate a need for further interventions to decrease antibiotic use for RTIs.