Lam Tai Pong, Ho Pak Leung, Lam Kwok Fai, Choi Kin, Yung Raymond
Family Medicine Unit, Department of Medicine, The University of Hong Kong, Hong Kong.
Asia Pac Fam Med. 2009 May 22;8(1):5. doi: 10.1186/1447-056X-8-5.
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.
确定基层医疗医生对抗生素的使用情况。
邀请香港的全科医生,从2005年12月开始,每三个月的第一个完整工作日,就他们诊治的每一位感染患者填写一份简短问卷,连续四个季度。
46名基层医疗医生参与,共回收3096份完整问卷。前三大诊断分别为上呼吸道感染(46.7%)、胃肠道感染(8.2%)和咽炎(7.1%)。30%的感染患者就诊时被开具了抗生素,但上呼吸道感染(URTI)患者就诊时仅5.2%被开具抗生素。氨基青霉素是最常用的抗生素,而β-内酰胺/β-内酰胺酶抑制剂组合(BLBLIs)是第二常用的抗生素,它们分别占所有使用抗生素的16.5%和14.0%。在所有患者或其护理人员中,要求或希望使用抗生素的人更有可能被开具抗生素(Pearson卡方检验,p < 0.0001)。那些前来医生处进行随访咨询的患者也更有可能被开具抗生素(Pearson卡方检验,p < 0.001)。
香港基层医疗医生的抗生素处方模式与其他发达国家的基层医疗医生大致相似,但上呼吸道感染使用抗生素的比例相对较低。