Attitudes of Spanish family physicians about preferences for using antibacterial drugs for patients diagnosed of having acute bronchitis

Abstract

Pharma Aim : To know the attitudes of Spanish physicians related antibiotic use in different patterns of acute bronchitis. Design: A cross-sectional survey was set out in November during the Spanish Conference on Medicine Family held in Donosti (Basque Country). Methods : All the participants who filled up a questionnaire were given a present at the Aventis Pharma's stand at the Conference. They were asked if they would prescribe antibiotics in cases of acute bronchitis accompanied with high temperature, purulent sputum, uncertainty in the diagnosis and in the cases in which patients wanted with treatment antibiotic. Results : 843 family doctors filled up the questionnaire and 35 inquiries were dropped out because of illegibility or non responses. Out of the 784 valid responses reported, 569 doctors preferred to use antibiotics in cases of acute bronchitis with a temperature higher than 38ºC (72.6%)-175 physicians strongly agreed with this sentence (22.3%)-, 662 preferred to use them in case of a purulent sputum (84.5%)-234 strongly agreed (29.9)-, 131 stated that they would prescribe antibiotics when patients really wanted them (16.9%) and 603 would prescribed antibacterial agents in case of suspected pneumonia (77.7%)-115 strongly agreed with that sentence (14.8 Conclusions : Despite the fact that antibiotics are ineffective in acute bronchitis many doctors would prescribe them mainly in cases of uncertainty and in cases of purulent sputum justifying the high consumption of antibiotics in our country. ABI034: Additional value of spirometry in risk assessment of acute respiratory disease in winter among patients with mild to moderate asthma or COPD (Prim Care Respir J 2002; 11(2): 66) Background: Spirometry is frequently performed by Dutch general practitioners to diagnose and monitor asthma or COPD. However, its additional value to anamnestic data in predicting the occurrence of acute respiratory disease (ARD) is unknown. We developed a clinical prediction model, assessing the additional value of spirometry, for the risk of asthma/COPD exacerbation or pneumonia during an influenza epidemic. Methods: Data were used from a case-control study among patients with asthma or COPD aged 18-64 years in general practice. During the influenza epidemics of 1998-1999 and 1999-2000, data on demographics, prior health care use, medical consumption, type of lung disease and comorbidity were collected from 87 patients with an exacerbation or pneumonia and 363 controls matched on age en sex using computerized medical records. Additionally, FEV 1 and PEF were measured before and after inhalation of a ß-agonist. Conditional multivariate logistic regression analysis and receiver-operator curve (ROC) analysis was used to assess the discriminative value of anamnestic data and spirometry. Results: Independent predictors of the occurrence of ARD were 'prior exacerbation' (OR 6.3 95% CI 3.3-12.3), 'use of bronchodilators' (OR 2.0, 95% CI 1.3-3.8), 'treatment by pulmonologist' (OR 2.0, 95% CI 1.2-3.4) and 'COPD' (OR 1.7, 95%CI 0.9-3.0)....