Antibiotics Over-Prescribed By Doctors

General Practitioners (GPs) are unnecessarily giving patients antibiotics for respiratory tract (RT) infections, which would otherwise resolve on their own, claims a new report.

Researchers from the University Medical Center (UMC, Utrecht, The Netherlands) examined data from the Second Dutch National Survey of General Practice (DNSGP-2) involving 163 GPs from 85 Dutch practices, serving a population of 359,625 patients. Data over a 12-month period were analyzed by means of multiple linear regression analysis. Main outcome measure was the volume of antibiotic prescriptions for acute RT episodes per 1,000 patients. The researchers also carried out a survey of the doctors' attitudes to prescribing antibiotics for RT infections.

The researchers found that the GPs labeled about 70% of acute RT episodes as infections, and antibiotics were prescribed in 41% of all acute RT episodes. Diagnostic labeling (the tendency to encode RT episodes as infections rather than as symptoms) seemed to be an arbitrary process, often used to justify antibiotic prescribing. Doctors tended to over-emphasize symptoms such as white spots in the throat, rather than looking at factors such as old age and co-morbidity, which would affect a patient's recovery. The researchers suggested GPs may give out antibiotics unnecessarily to defend themselves against unforeseen complications, even if these are unlikely to materialize. The study was published on September 20, 2007, in the BioMed Central (BMC) online open access journal, BMC Family Practice.

"Even in the Netherlands there is an over-prescribing of antibiotics; about 50% of the antibiotic prescriptions for acute RT episodes are not in accordance with Dutch national guidelines,” said lead author Dr. Huug J. van Duijn. "Considering costs, side-effects and the growing resistance to pathogens, it is important to rationalize antibiotic prescribing as much as possible.”


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