Use of antibiotics by primary care doctors in Hong Kong
To determine the use of antibiotics by primary care doctors.
General practitioners in Hong Kong were invited to fill in a short questionnaire on every patient with infection that they had seen on the first full working day once every three months for four consecutive quarters starting from December 2005.
Forty six primary care doctors took part and a total of 3096 completed questionnaires were returned. The top three diagnoses were upper respiratory tract infection (46.7%), gastrointestinal infection (8.2%) and pharyngitis (7.1%). Thirty percent of patient encounters with infections were prescribed antibiotics but only 5.2% of patient encounters with upper respiratory tract infection (URTI) were prescribed antibiotics. Amino-penicillins were the most commonly used antibiotics while beta-lactam/beta-lactamase inhibitor combinations (BLBLIs) were the second most commonly used antibiotics and they accounted for 16.5% and 14.0% of all antibiotics used respectively. Of all patients or their carers, those who demanded or wished for antibiotics were far more likely to be prescribed antibiotics (Pearson chi-square test, p < 0.0001). Those patients who were attending the doctors for follow-up consultations were also more likely to be prescribed antibiotics (Pearson chi-square test, p < 0.001).
The antibiotic prescribing patterns of primary care doctors in Hong Kong are broadly similar to primary care doctors in other developed countries but a relatively low rate of antibiotics is used for URTI.
- Arroll B, Goodyear-Smith F: General practitioner management of upper respiratory tract infections: when are antibiotics prescribed? New Zealand Medical Journal 2000,113(1122):493–496.
- Wang EE, Einarson TR, Kellner JD, Conly JM: Antibiotics prescribing for Canadian preschool children: evidence of overprescribing for viral respiratory infections. Clinical Infectious Disease 1999,29(1):155–160. CrossRef
- Chung A, Perera R, Brueggemann A, Elamin AE, Harnden A, Mayon-White R, Smith S, Crook DW, Mant D: Effect of antibiotic prescribing on antibiotic resistance in individual children in primary care: prospective cohort study. BMJ 2007,335(7617):429. CrossRef
- Belongia EA, Schwartz B: Strategies for promoting judicious use of antibiotics by doctors and patients. BMJ 1998, 317:668–671.
- Seppala H, Klaukka T, Vuopio-Varkula J, Muotiala A, Helenius H, Lager K, Huovinen P: The effect of changes in the consumption of macrolide antibiotics on erythromycin resistance in group A streptococci in Finland. N Eng J Med 1997, 337:441–446. CrossRef
- Arroll B, Kenealy T: Antibiotics for the common cold. Cochrane Database Syst Rev 2000, (2):CD000247.
- Mainous AG III, Hueston WJ: The cost of antibiotics in treating upper respiratory tract infections in a Medicaid population. Arch Fam Med 1999, 7:45–49. CrossRef
- Little P, Gould C, Williamsen I, Warner G, Gantly M, Kinmonth AL: Reattendance and complications in a randomised trial of prescribing strategies for sore throat: the medicalising effect of prescribing antibiotics. BMJ 1997, 315:350–352.
- De Melker RA, Kuyvenhoven MM: Management of upper respiratory tract infections in Dutch family practice. J Fam Pract 1994, 38:353–357.
- Little P, Williamson I, Warner G, Gould C, Gantley M, Kinmonth AL: Open randomised trial of prescribing strategies in managing sore thoat. BMJ 1997, 314:722–727.
- Orr PH, Scherer K, MacDonald A, Moffatt ME: Randomized placebo-controlled trials of antibiotics for acute bronchitis: a critical review of the literature. J Fam Pract 1993, 36:507–512.
- Gonzales R, Sande M: What will it take to stop physicians from prescribing antibiotics in acute bronchitis? Lancet 1995, 345:665–666. CrossRef
- Verjeij TJ, Hermans J, Mulder JD: Effects of doxycycline in patients with acute cough and purulent sputum: a double-blind, placebo-controlled trial. Br J Gen Pract 1994,44(386):400–404.
- Del Mar C: Prescribing antibiotics in primary care. BMJ 2007, 335:407–408. CrossRef
- King DE, Williams WC, Bishop L, Shechter A: Effectiveness of erythromycin in the treatment of acute bronchitis. J Fam Pract 1996, 42:601–605.
- Heikkinen T, Ruuskanen O, Ziegler T, Waris M, Puhakka H: Short-term use of amoxicillin-clavulanate during upper respiratory tract infection for prevention of acute otitis media. J Paediatr 1995, 126:313–316. CrossRef
- Kaiser L, Lew D, Hirschel B, Auckenthaler R, Morabia A, Heald A, Benedict P, Terrier F, Wunderli W, Matter L, Germann D, Voegeli J, Stalder H: Effects of antibiotic treatment in the subset of common-cold patients who have bacteria in nasopharyngeal secretions. Lancet 1996, 347:1507–1510. CrossRef
- Lam TP, Lam KF: Why do family doctors prescribe antibiotics for upper respiratory tract infection? International Journal of Clinical Practice 2003,57(3):167–169.
- Lam TP, Lam KF: What are the non-biomedical reasons which make family doctors over-prescribe antibiotics for upper respiratory tract infection in a mixed private/public Asian setting? Journal of Clinical Pharmacy and Therapeutics 2003, 28:197–201. CrossRef
- Mikstra Programme – antimicrobial treatment strategies [http://finohta.stakes.fi/EN/mikstra/index.htm]
- Petersen I, Hayward A, SACAR Surveillance Subgroup: Antibacterial prescribing in primary care. J Antimicrob Chemother 2007,60(Suppl 1):i43–47. CrossRef
- Ho PL, Cheung C, Mak GC, Tse CW, Ng TK, Cheung CH, Que TL, Lam R, Lai RW, Yung RW, Yuen KY: Molecular epidemiology and household transmission of community-associated methicillin-resistant Staphlococcus aureus in Hong Kong. Diagnostic Microbiology and Infectious Disease 2007,57(2):145–151. CrossRef
- Petursson P: GPs' reasons for "non-pharmacological" prescribing of antibiotics. A phenomenological study. Scand J Prim Health Care 2005,23(2):120–125. CrossRef
- Use of antibiotics by primary care doctors in Hong Kong
- Open Access
- Available under Open Access This content is freely available online to anyone, anywhere at any time.
Asia Pacific Family Medicine
- Online Date
- May 2009
- Online ISSN
- BioMed Central
- Additional Links
- Author Affiliations
- 1. Family Medicine Unit, Department of Medicine, The University of Hong Kong, Hong Kong
- 2. Department of Microbiology, The University of Hong Kong, Hong Kong
- 3. Department of Statistics and Actuarial Science, The University of Hong Kong, Hong Kong
- 4. Hong Kong Medical Association, Hong Kong
- 5. Hong Kong Sanatorium & Hospital, Hong Kong