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Review paper

Antibiotic prescription rate for upper respiratory tract infections in general practice – a Croatian study

By
Anja Gačina Orcid logo ,
Anja Gačina
Contact Anja Gačina

Family Practice, Samobor, Samobor, Croatia

Marija Vrca Botica ,
Marija Vrca Botica

Department of Family Medicine, School of Public Health ‘’Andrija Štampar’’ University of Zagreb, Zagreb, Croatia

Iva Botica ,
Iva Botica

Department of Otorhinolaryngology and Head and Neck Surgery, University Hospital ‘’Rebro’’ Zagreb, Zagreb, Croatia

Andrea Horvat Hodžić ,
Andrea Horvat Hodžić

Family Practice, Zdenčina, Zdenčina, Croatia

Iva Borovečki Žuti ,
Iva Borovečki Žuti

Private Family Practice, Gornja Stubica, Croatia

Antonio Kobaš
Antonio Kobaš

Private Family Practice, Gornja Stubica, Croatia

Abstract

Aim
Acute upper respiratory tract infections are the most common indication for antibiotic prescribing in primary care. The frequency of antibiotics prescribed to patients with upper respiratory tract infections has been studied.
Methods
A cross-sectional survey has been conducted from October to December 2017 with participation of 17 General Practices in Croatia. Visits of patients with symptoms of upper respiratory tract infections made the survey framework. A specially structured questionnaire was a tool for the assessment of reasons for encounters, clinical statuses and practitioners' decisions. According to the registered clinical status, two independent doctors classified patients using Centor criteria, which were used to evaluate appropriate indication for antibiotic prescription.
Results
The survey analysed 709 patients' visits. Seventy three percent of general practice visits due to acute respiratory tract infection were initial. Antibiotics had been prescribed in the total of 32.6% of cases. Analysing upper respiratory tract infections with Centor score 1 and 2, antibiotics had been prescribed in 22.8% cases of the first visit and in 31.7% of the second visit, and with the Centor score 3 and 4 antibiotics had been prescribed in 85.1% of cases during the initial visit, and 66.7% of cases during the second visit. Logistic regression analysis about the contribution of nonclinical variables to antibiotic prescribing showed that most often antibiotics had been prescribed on Mondays. The most prescribed group of antibiotics was the penicillin group (74.8%), followed by macrolides (17.6%) and cephalosporins (4.0%).
Conclusion
General practitioners prescribe antibiotics for acute respiratory tract infections more than recommended by evidence based medicine and professional criteria.

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