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Factors influencing antibiotic prescribing for respiratory tract infections in primary care–a comparison of physicians with different antibiotic prescribing rates
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- Cronberg, Olof (author)
- Lund University,Lunds universitet,Allmänmedicin och samhällsmedicin,Forskargrupper vid Lunds universitet,Family Medicine and Community Medicine,Lund University Research Groups,Region Kronoberg,Vaxjohalsan Primary Healthcare Ctr, Sweden; Reg Kronoberg, Sweden; Lund Univ, Sweden; VC Vaxjohalsan, Sweden
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- Tyrstrup, Mia (author)
- Lund University,Lunds universitet,Allmänmedicin och samhällsmedicin,Forskargrupper vid Lunds universitet,Family Medicine and Community Medicine,Lund University Research Groups,Lund Univ, Sweden; Lundbergsgatan Primary Hlth Care Ctr, Sweden
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- Ekblom, Kim (author)
- Umeå University,Reg Kronoberg, Sweden; Umea Univ, Sweden
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- TAYLOR & FRANCIS LTD, 2024
- 2024
- English.
- In: Scandinavian Journal of Primary Health Care. - : TAYLOR & FRANCIS LTD. - 0281-3432 .- 1502-7724.
- Journal article (peer-reviewed)
Abstract
Subject headings
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- Background: There has been a notable decrease in antibiotic prescribing in the last thirty years in Sweden. Little is known about factors influencing antibiotic prescribing over several years. Objective: To compare primary care physicians who, over time, reduced their antibiotic prescribing for respiratory tract infections with those who remained either high or low prescribers regarding potentially influencing factors. Design and setting: A register-based study including all RTI visits in primary care in Region Kronoberg, Sweden 2006–2014. The data were divided into three 3-year periods. Subjects: The data comprised all physicians who had diagnosed at least one RTI for each of the three-year periods. The antibiotic prescribing rate adjusted for the patients’ sex and age group was calculated for each physician and period, and based on the change between the first and the third period, the physicians were divided into three prescriber groups: The High Prescribing Group, the Decreasing Prescribing Group, and the Low Prescribing Group. Main outcome measures: For the three prescriber groups, we compared factors influencing antibiotic prescribing such as the characteristics of the physicians, their use of point-of-care tests, their choice of diagnoses, and whether the patients returned and received antibiotics. Results: The High Prescribing Group ordered more point-of-care tests, registered more potential bacterial diagnoses, prescribed antibiotics at lower C-reactive protein levels, and prescribed antibiotics more often despite negative group A Streptococci test than in the Low Prescribing Group. The Decreasing Prescribing Group was between the High Prescribing Group and the Low Prescribing Group regarding these variables. The lower prescription rate in the Low Prescribing Group did not result in more return visits or new antibiotic prescriptions within 30 days. Conclusion: Point-of-care testing and its interpretation differed between the prescriber groups. Focus on interpreting point-of-care test results could be a way forward in antibiotic stewardship.
Subject headings
- MEDICIN OCH HÄLSOVETENSKAP -- Klinisk medicin -- Allmänmedicin (hsv//swe)
- MEDICAL AND HEALTH SCIENCES -- Clinical Medicine -- General Practice (hsv//eng)
Keyword
- Antibiotic prescribing
- diagnosis-linked prescription
- infectious disease
- physicians’ behaviour
- point-of-care testing
- Antibiotic prescribing; diagnosis-linked prescription; infectious disease; physicians' behaviour; point-of-care testing
Publication and Content Type
- art (subject category)
- ref (subject category)
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- Cronberg, Olof
- Tyrstrup, Mia
- Ekblom, Kim
- Hedin, Katarina
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- Linköping University
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