Comparative information on diagnosis-related antibiotic prescribing patterns are scarce from primary care within and between countries. To describe and compare antibiotic prescription and routine management of infections in primary care in Latvia (LV), Lithuania (LT) and two study sites in Sweden (SE), a cross-sectional observational study on patients who consulted due to sypmtoms compatible with infection was undetraken. Infection and treatment was detected and recorded by physicians only. Data was collected from altogether 8786 consecutive patients with infections in the three countries. Although the overall proportion of patients receiving an antibiotic prescription was similar in all three countries (LV and LT 42%, SE 38%), there were differences in the rate of prescription between the countries depending on the respective diagnoses. While penicillins dominated among prescriptions (LV 58%, LT 67%, SE 70%), phenoxymethylpenicillin was most commonly prescribed in Sweden (57% of all penicillins), while it was amoxicillin with or without clavulanic acid in Latvia (99%) and Lithuania (85%) respectively. Pivmecillinam and flucloxacillin, which accounted for 29% of penicillins in Sweden, were available neither in Latvia nor in Lithuania. The applied methodology was simple, and provided useful information on differences in treatment of common infections in ambulatory care in the absence of available computerized diagnosis–prescription data. Despite some limitations, the method can be used for assessment of intention to treat and compliance to treatment guidelines and benchmarking locally, nationally, or internationally, just as the point prevalence surveys (PPS) protocols have been used in hospitals all over Europe.

Prudent use of antibiotics is important to delay the spread of resistance. This paper analyses the effect on children's antibiotics use of a reform of the temporary parental benefit in Sweden. The reform increased the maximum compensation for this benefit. The level of compensation for social security may affect the propensity of a patient or parent to push for a prescription for antibiotics, as a less generous compensation makes it more expensive to be absent from work and since there is widespread overconfidence in the effectiveness of antibiotics. Using municipality level data, we show that the reform resulted in a reduction in children's antibiotics use by about five per cent. The result is fairly robust to alternative empirical strategies, suggesting that welfare policies can have important indirect effects that should be taken into account.