Zweigner, Janine, Meyer, Elisabeth, Gastmeier, Petra ORCID: 0000-0001-5520-4287 and Schwab, Frank (2018). Rate of antibiotic prescriptions in German outpatient care - are the guidelines followed or are they still exceeded? GMD Hyg. Infect. Control, 13. DUESSELDORF: GERMAN MEDICAL SCIENCE-GMS. ISSN 2196-5226

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Abstract

Aim: The consequences of antibiotic overuse are substantial. We combined and analyzed the infection diagnoses and antibiotic prescribing practices of physicians in outpatient settings. Recommendations for targeting policy efforts to focused areas are given. Methods: Antibiotic prescriptions and infections diagnosed were provided by a German statutory health insurance provider over a 12-month period. Antibiotic use was expressed as prescriptions per 100 patients. Results: 2,594,000 patient-physician contacts within twelve months were analyzed. A median of 6.5 antibiotics was prescribed to 100 patients. Antibiotic use in private practice showed large variations between and within medical specialties (the upper quarter of physicians who prescribed above the 75th percentile of all prescriptions, at a rate of approximately 43%), by season (antibiotic prescription was 50% higher in winter than in summer) and a considerable proportion of the antibiotics prescribed did not conform with the recommendations of national guidelines. Fluoroquinolones, predominantly ciprofloxacin, were among the top three antibiotics prescribed by all physicians (except pediatricians), although national guidelines do not recommend these agents for uncomplicated respiratory or urinary tract infections. Respiratory tract infections headed the list for the prescription of antibiotics. Conclusions: Antibiotics were still not prescribed appropriately in respect to indication and selection (often unnecessary and/or too broad). We recommend focusing on I) high/over-prescribers, because improved and appropriate antibiotic prescription by this group would result in an over-proportionally lower antibiotic prescription rate, II) respiratory tract infections, because they represent the vast majority of infections treated in primary care and III) intelligent implementation strategies of guidelines.

Item Type: Journal Article
Creators:
CreatorsEmailORCIDORCID Put Code
Zweigner, JanineUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Meyer, ElisabethUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Gastmeier, PetraUNSPECIFIEDorcid.org/0000-0001-5520-4287UNSPECIFIED
Schwab, FrankUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
URN: urn:nbn:de:hbz:38-192775
DOI: 10.3205/dgkh000310
Journal or Publication Title: GMD Hyg. Infect. Control
Volume: 13
Date: 2018
Publisher: GERMAN MEDICAL SCIENCE-GMS
Place of Publication: DUESSELDORF
ISSN: 2196-5226
Language: English
Faculty: Unspecified
Divisions: Unspecified
Subjects: no entry
Uncontrolled Keywords:
KeywordsLanguage
AMBULATORY-CARE; EUROPE; CONSUMPTION; ADULTS; TRIALMultiple languages
Public, Environmental & Occupational HealthMultiple languages
Refereed: Yes
URI: http://kups.ub.uni-koeln.de/id/eprint/19277

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