Programme no. 360-P
Unnecessary antibiotic prescribing for upper respiratory tract infections in general practice - difference between patient genders?
Kathrine Bagger*1, Lars Bjerrum2, Volkert Dirk Siersma3, Anni Brit Sternhagen Nielsen4
1Department of Public Health,Section and Research Unit of General Practice, University of Copenhagen,1014 Copenhagen K,Denmark, 2Section and Research Unit of General Practice, University of Copenhagen,1014 Copenhagen K,Denmark, 3Department of Public Health,Section and Research Unit of General Practice, University of Copenhagen,1014 Copenhagen K,Denmark, 4Department of Public Health,Section and Research Unit of General Practice, University of Copenhagen,1014 Copenhagen K,Denmark
* = Presenting author
Objectives: To study a possible gender difference in inappropriate antibiotic prescriptions for URTIs in general practice; to assess whether a possible difference is explained by patient demand for antibiotics.
Background: Inappropriate prescribing of antibiotics is a major public health problem causing the development of antibiotic resistant bacteria. General practitioners (GPs) prescribe the majority of antibiotics, often for upper respiratory tract infections (URTIs), and have in general been shown to prescribe antibiotics more often to women than men. No studies have examined the influence of patient gender on inappropriate antibiotic prescribing.
Results: A total of 25% of patients with URTI received antibiotics; in 45% of the cases antibiotics were inappropriate. Sweden and Denmark had the lowest rates of inappropriate antibiotic prescribing. Overall, we found no gender differences for inappropriate prescribing of antibiotics for URTIs. Women with acute otitis media received an inappropriate recipe of antibiotic twice as often as men (14.4% vs. 7.1%). In Danish patients with acute pharyngotonsillitis, there was a gender difference in inappropriate prescriptions for antibiotics (women 29.1% vs. men 48.6%). Some 14% of patients receiving inappropriate antibiotics demonstrated a demand for antibiotics, but we found no gender difference in this group.
Material/Methods: A cross-sectional study including 15,022 patients with URTI (acute rhinitis, acute otitis media, acute sinusitis, acute pharyngotonsillitis) from Denmark, Sweden, Lithuania, Russia, Spain and Argentina (HAPPY AUDIT Project). We analysed the association between gender and inappropriate antibiotic prescriptions, unadjusted and adjusted for treatment demand, using logistic regression models.
Conclusion: This study indicated a high rate of inappropriate antibiotic prescribing for URTIs in general practice, but overall found no gender differences with regard to receiving inappropriate antibiotic prescriptions.
Points for discussion: How can we decrease inappropriate use of antibiotics for URTI?
Why are the rate of inappropriate antibiotics twice as high for women than men suffering from acute otitis media?
Why are the rate of inappropriate antibiotics higher for men than women suffering from pharyngotonsillitis in Denmark and not in other countries?
How can we refuse demands for antibiotics without loosing a good patient-doctor relation?