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Respiratory tract infections in general practice: considerable differences in prescribing habits between general practitioners in Denmark and Spain

  • Pharmacoepidemiology and Prescription
  • Published:
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Abstract

Objective

The prevalence of antibiotic resistance in a country reflects the local consumption of antibiotics. The majority of antibiotics are prescribed in general practice and most prescriptions are attributable to treatment of respiratory tract infections (RTIs). The aim of this study was to compare general practitioners’ (GPs’) prescribing of antibiotics for respiratory tract infections in a country with a high prevalence of antibiotic resistance (Spain) with a country with a low prevalence of antibiotic resistance (Denmark).

Methods

A group of GPs in Copenhagen and Barcelona registered all contacts (n=2833) with patients with RTIs during a 3-week period between 1 November 2001 and 31 January 2002.

Results

Overall, Spanish GPs treated a higher proportion of patients than Danish GPs. After adjusting for unequal distribution of age and sex, we found that Spanish GPs prescribed significantly more antibiotics to patients with focus of infection in tonsils and bronchi/lungs. Narrow-spectrum penicillin was the most used antibiotic in Denmark, representing 58% of all prescriptions issued, followed by macrolide and broad-spectrum penicillin. In Spain, prescriptions were distributed among a great number of compounds, with broad-spectrum penicillins and combinations of amoxicillin plus betalactamase inhibitors most frequently used.

Conclusion

The substantial difference in the way GPs manage respiratory tract infections in Denmark and Spain cannot be explained by different patterns of RTIs in general practice. The discrepancies indicate variations in national recommendations, different treatment traditions or different impact of pharmaceutical marketing.

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Acknowledgements

The authors wish to thank the general practitioners in Copenhagen and Barcelona for their participation in the study. The study was supported by a grant from the Danish “The Health Insurance Foundation”.

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Authors and Affiliations

  1. Research Unit of General Practice, University of Southern Denmark, Winsløwsparken 19, 3rd floor, 5000 , Odense C, Denmark

    Lars Bjerrum

  2. Catalan Society of Family Medicine, Barcelona, Spain

    Albert Boada, Josep M. Cots, Carlos Llor & Dolors Forés Garcia

  3. Department of Clinical Microbiology, Odense University Hospital, Denmark

    Bente Gahrn-Hansen

  4. Audit Project Odense, Research Unit of General Practice, University of Southern Denmark, Denmark

    Anders Munck

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  1. Lars Bjerrum
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  2. Albert Boada
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  3. Josep M. Cots
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  4. Carlos Llor
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  6. Bente Gahrn-Hansen
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  7. Anders Munck
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Correspondence to Lars Bjerrum.

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Bjerrum, L., Boada, A., Cots, J.M. et al. Respiratory tract infections in general practice: considerable differences in prescribing habits between general practitioners in Denmark and Spain. Eur J Clin Pharmacol 60, 23–28 (2004). https://doi.org/10.1007/s00228-003-0706-z

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  • DOI: https://doi.org/10.1007/s00228-003-0706-z

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