Differences in Antibiotic Prescribing Patterns Between General Practitioners in Scandinavia: A Questionnaire Study

Abstract

There has been a dramatic increase in the prevalence of antibiotic-resistant bacteria worldwide. In the Scandinavian countries at least 90% of total antibiotic use relates to outpatients and therefore it has become increasingly important to know the antibiotic prescription pattern of general practitioners (GPs) in order to implement and monitor changes in antibiotic prescribing. The aim of the present study was to evaluate the prescription patterns of GPs in Denmark, Norway and Sweden. In order to achieve a reasonable comparison, a questionnaire consisting of 7 case reports concerning upper and lower respiratory tract infections, urinary tract infections and skin and soft tissue infections was sent to 1,000 GPs in the 3 countries. In general, the guidelines for the treatment of bacterial infections in the individual countries were followed by the responders. In all 3 countries, penicillin V was still the drug most frequently used in upper and lower respiratory tract infections. The greatest difference in prescribing patterns among the countries was seen in the treatment of urinary tract infections, recurrent pharyngeal tonsillitis, acute otitis media and acute exacerbation of chronic bronchitis. There were also differences in the dosing regimens, length of treatment and use of diagnostic techniques.

Antimicrobial prescribing trends in primary care: implications for health policy in Bahrain

“…21,22 Despite availability as an essential drug for primary care in Bahrain and its proven efficacy, safety, targeted spectrum and low cost, 23 penicillin V was never prescribed by either FPs or GPs, although children !4 and 12 years comprised 540 (60.4%) of overall children (1-12 years) those receiving antibacterials (data not shown). In contrast, penicillin V was the most frequently prescribed antibiotic (70% of prescriptions) for patients with RTIs in three Nordic countries 24 and ranked the second most frequent after macrolides, in Germany. 25 In order to minimize complications of empirical treatment of RTIs (which seem the practice of majority of primary care physicians) with potential emergence of antimicrobial resistance, the following recommendations should be considered:…”

Pattern of Upper Respiratory Tract Infections and Physicians’ Antibiotic Prescribing Practices in Bahrain

“…Surprisingly, only 2 doctors indicated that they were likely to prescribe penicillin V, which has been proven to be cheap and safe, with a targeted spectrum and be effective for group A ␤ -haemolytic streptococci. It was found to be the most commonly prescribed antibiotic for patients with URTI in a survey of doctors in 3 Scandinavian countries and ranked second to macrolides in Germany [19][20][21] . However, this drug was not prescribed for any patient during the study period and the top 3 antibiotics prescribed were amoxicillin, amoxicillin/clavulanate and cefaclor.…”

Management of acute maxillary sinusitis in Finnish primary care Results from the nationwide MIKSTRA study

“…Use of macrolides and cephalosporins was higher than recommended in the national guidelines. Finnish physicians do not consider penicillin V as an effective antibiotic for AMS and it was used much less than in other Nordic countries (26).…”