Stürchler M S, Vuille P, Zemp E, Tschudi P, Zimmerli W
Abteilung für Infektiologie, Departement Innere Medizin, Universitätskliniken Basel.
Schweiz Med Wochenschr. 2000 Oct 14;130(41):1437-46.
The study aim was to analyse the diagnostic and therapeutic approach to selected infectious diseases, in particular with regard to the use of antibiotics, in the light of current guidelines and the problem of developing resistance.
A questionnaire was sent to all physicians with a general or internal medicine practice in the Cantons Basel-Stadt and Basel-Landschaft, Switzerland.
Of 440 physicians, 286 (65%) took part in the study. The most frequent diagnoses of infection were cystitis (16.6%), flu-like syndrome (16.4%), acute bronchitis (12.3%), and tonsillopharyngitis (10.1%). The most frequent indications for antimicrobial therapy were cystitis (19.9%), acute sinusitis (14.1%), acute bronchitis (11.5%), and tonsillopharyngitis (9.2%). Macrolides (24.0%), aminopenicillins (22.6%), and fluoroquinolones (16.8%) were the most frequently prescribed antibiotics.
The majority of physicians diagnosed and treated according to rational principles. However, a few exceptions were found, e.g. omission of x-ray in the diagnosis of pneumonia (24%), the use of antibiotics in the treatment of viral diseases and antibiotic therapy for tonsillopharyngitis despite a negative rapid antigen detection test against group A streptococci (75%).
本研究旨在根据当前指南以及耐药性问题，分析对特定传染病的诊断和治疗方法，尤其是抗生素的使用情况。
向瑞士巴塞尔市和巴塞尔乡村地区所有从事普通内科或内科医疗工作的医生发送了一份调查问卷。
440名医生中，286名（65%）参与了研究。最常见的感染诊断为膀胱炎（16.6%）、流感样综合征（16.4%）、急性支气管炎（12.3%）和扁桃体咽炎（10.1%）。抗菌治疗最常见的指征为膀胱炎（19.9%）、急性鼻窦炎（14.1%）、急性支气管炎（11.5%）和扁桃体咽炎（9.2%）。最常开具的抗生素为大环内酯类（24.0%）、氨基青霉素类（22.6%）和氟喹诺酮类（16.8%）。
大多数医生按照合理原则进行诊断和治疗。然而，也发现了一些例外情况，例如在肺炎诊断中未进行X光检查（24%）、在病毒疾病治疗中使用抗生素以及尽管针对A组链球菌的快速抗原检测呈阴性但仍对扁桃体咽炎进行抗生素治疗（75%）。
