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- André, Malin, 1949-, et al.
(författare)
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Diagnosis-prescribing surveys in 2000, 2002 and 2005 in Swedish general practice : Consultations, diagnosis, diagnostics and treatment choices
- 2008
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Ingår i: Scandinavian Journal of Infectious Diseases. - : Informa UK Limited. - 0036-5548 .- 1651-1980. ; 40:8, s. 648-654
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Tidskriftsartikel (refereegranskat)abstract
- The aim of this study is to present diagnostic patterns, diagnostics used and antibiotic treatment in relation to guidelines in 3 repeated diagnosis-prescription studies conducted simultaneously in general practice in 5 Swedish counties, during 1 week in November 2000, 2002 and 2005. General practitioners (GPs) at the participating health centres were asked to complete a form for all patients with symptoms of an infectious disease. During the studied periods a total of 15,371 consultations was registered. Consultations with GPs diagnosed as respiratory tract infection (RTI), especially consultations for sore throat, decreased considerably between y 2000 and 2005. The percentage of patients allocated an RTI diagnosis and prescribed an antibiotic declined significantly from 54% to 49% and the decline was most pronounced among children. Penicillin V remained the dominant antibiotic prescribed throughout the study periods. For lower urinary tract infections there was a significant change in choice of prescribed antibiotics with an increase for pivmecillinam and nitrofurantoin and a decrease for trimethoprim, in accordance with recommendations. The results indicate a quite close adherence to current guidelines, with changes in the pattern of consultations as well as in the management of infectious diseases in general practice in Sweden.
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- André, Malin, 1949-, et al.
(författare)
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The management of infections in children in general practice in Sweden. : a repeated 1-week diagnosis-prescribing study in 5 counties in 2000 and 2002.
- 2005
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Ingår i: The Journal of Infectious Diseases. - : Informa UK Limited. - 0022-1899 .- 0036-5548 .- 1651-1980. ; 37:11-12, s. 863-869
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Tidskriftsartikel (refereegranskat)abstract
- A diagnosis-prescribing study was performed in 5 Swedish counties during 1 week in November in 2000 and repeated in 2002. The aim of the present study was to analyse data for children 0-15y of age who consulted a general practitioner with symptoms of an infection. During the 2 weeks studied, 4049 children were consulted. Respiratory tract infections (RTI) were the predominant diagnoses, above all among the youngest children, while the proportion of urinary tract infections and skin infections increased with increasing age. Between the y 2000 and 2002, the proportion of children allocated the diagnosis streptococcal tonsillitis and pneumonia decreased (p<0.01 and p<0.001, respectively) while the proportion of common cold increased (p<0.001). Antibiotic prescribing decreased from 55% to 48% (p<0.001) for respiratory infections between the years studied. The only significant changes in type of antibiotics prescribed were the increase of isoxazolylpenicillins (p<0.001) used for skin infection and the decrease of macrolides (p=0.001). A diagnostic test was used in more than half of the consultations. Of children allocated a RTI diagnosis, 36% were prescribed antibiotics when a C-reactive protein test was performed compared to 58% in those not tested. Further studies are needed in general practice to determine the optimal use of near-patient tests in children with RTI.
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- Axelsson, Inge, 1947-, et al.
(författare)
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Luftvägsinfektioner hos barn och vuxna
- 2009
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Ingår i: Läkemedelsboken 2009-2010. - Stockholm : Apoteket AB. ; , s. 670-695
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Bokkapitel (övrigt vetenskapligt/konstnärligt)abstract
- Luftvägsinfektioner är en av de vanligaste orsakerna till ett akut besök i sjukvården. Antalet läkarbesök och antibiotikarecept ökar markant några veckor efter daghemseller skolstarten och minskar under lovperioder. Hos läkare och allmänhet finns en ökad medvetenhet om nödvändigheten av att vara försiktig med antibiotika. Flera studier har visat att nyttan av antibiotika är liten vid flera av våra vanligaste bakteriella infektioner, vilket också framkommit i de nya nationella rekommendationerna för handläggning av öroninflammationer (år 2000), halsinfektioner (år 2001), bihåleinfektioner (år 2005) och nedre luftvägsinfektioner (år 2008) (, ). En hög följsamhet till barnvaccinationsprogrammet och en hög vaccinationsgrad av äldre mot influensa och pneumokocker förebygger infektioner och bakteriella komplikationer och medför minskad morbiditet och mortalitet. Förbättrad basal hygien, speciellt i småbarnsgrupper, med handtvätt, pappersnäsdukar och pappershanddukar kan minska infektionsspridning och sjuklighet i luftvägsinfektioner.
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