Antibiotic prescribing patterns in out-of-hours primary care: A population-based descriptive study

Abstract

Objective. To describe the frequency and characteristics of antibiotic prescribing for different types of contacts with the Danish out-of-hours (OOH) primary care service. Design. Population-based observational registry study using routine registry data from the OOH registration system on patient contacts and ATC-coded prescriptions. Setting. The OOH primary care service in the Central Denmark Region. Subjects. All contacts with OOH primary care during a 12-month period (June 2010–May 2011). Main outcome measures. Descriptive analyses of antibiotic prescription proportions stratified for type of antibiotic, patient age and gender, contact type, and weekdays or weekend. Results. Of the 644 777 contacts registered during the study period, 15.0% received an antibiotic prescription: 26.1% resulted from clinic consultations, 10.7% from telephone consultations, and 10.9% from home visits. The prescription proportion was higher for weekends (17.6%) than for weekdays (10.6%). The most frequently prescribed antibiotic drugs were beta-lactamase sensitive penicillins (34.9%), antibiotic eye drops (21.2%), and broad-spectrum penicillins (21.0%). Most antibiotic eye drops (73%) were prescribed in a telephone consultation. Most antibiotics were prescribed at 4–6 p.m. on weekdays. Young infants received most antibacterial eye drops (41.3%), patients aged 5–17 years and 18–60 years received most beta-lactamase sensitive penicillins (44.6% and 38.9%, respectively), while patients aged 60 + years received most broad-spectrum penicillins (32.9% of all antibiotic prescriptions). Conclusion. Antibiotics were most often prescribed in clinic consultations, but, in absolute terms, many were also prescribed by telephone. The high prescription proportion, particularly antibacterial eye drops for young infants, suggests room for improvement in rational antibiotic use.

Use of topical ocular antibiotics in young children: a Scandinavian drug utilization study

“…In Denmark, topical ocular antibiotics are often prescribed to children via telephone consultations and during weekends through out‐of‐hours primary care, that is, without clinical consultations (Huibers et al. ). In general practice, infectious conjunctivitis is often seen as ‘catch‐up consultations’, and physicians find it is easier and less time consuming to prescribe antibiotics than to explain the rationale behind declining to prescribe (Rose et al.…”

“…This is reflected in the fact that topical ocular antibiotics are often prescribed to young children by telephone consultations, that is, without a clinical consultation (Huibers et al. ).…”

Antibiotic prescribing during office hours and out-of-hours: a comparison of quality and quantity in primary care in the Netherlands

“…In addition, patients might exert more pressure for medical treatment, and GPs face a high workload and have less time and no personal relationship with the patient for communicating (non-) treatment considerations and advising alternative approaches. 8,9 These aspects could result in more irrational antibiotic prescribing. Higher antibiotic prescribing rates could, however, be justified during OOH, as patients are more likely to present with severe illness, often with fever, 10 or have higher risk of complications.…”

Drug prescriptions in Danish out-of-hours primary care: a 1-yearpopulation-based study

“…“Anti-infective drugs” (for systemic and local use) were by far the most frequently prescribed type of drugs and accounted for about 60% of all prescriptions made by the OOH service. [13] Other frequently prescribed types of drugs were “NSAIDs”, “opioids”, “adrenergic inhalants” and “antihistamines”.…”