Lambert Maarten, Veldkamp Renee, Weesie Yvette, Lambooij Anke, Cals Jochen W L, Taxis Katja, van Dijk Liset, Hek Karin
Unit of PharmacoTherapy, Epidemiology and Economics, Groningen Research Institute of Pharmacy, University of Groningen, Antonius Deusinglaan 1, Groningen 9713 AV, The Netherlands.
Nivel, Netherlands Institute for Health Services Research, Otterstraat 118, Utrecht 3515 CR, The Netherlands.
Fam Pract. 2025 Jun 4;42(4). doi: 10.1093/fampra/cmaf031.
Mapping general practitioners' antibiotic prescribing practices is essential to optimize antibiotic use in primary care and mitigate antibiotic resistance.
The objective of this study was to examine the adherence of Dutch general practitioners to prescribing guidelines for ear and respiratory tract symptoms and conditions.
A cross-sectional study was conducted on Dutch electronic health records from 2018 to 2021. Antibiotic prescribing frequency and type were examined for ear and respiratory tract symptoms and conditions based on professional prescribing guidelines. Descriptive statistics and multilevel logistic regression analyses were applied.
Patient records from up to 384 general practices were analysed for 15 ear and 27 respiratory tract conditions. For 11 of the 15 (73%) ear and 17 of the 27 (63%) respiratory tract conditions, more than 95% of patients were treated according to the prescribing guidelines. Most potential non-adherence to antibiotic prescribing guidelines occurred for acute otitis media (31%-34%), acute bronchitis/bronchiolitis (26%-39%), and acute sinusitis (25%-34%). Several other respiratory tract conditions showed non-indicated prescribing rates above 10%. For otitis externa, many broad-spectrum antibiotics were prescribed, which rarely happened for respiratory conditions. High variation in prescribing frequency and type between general practices occurred.
For most conditions, Dutch general practitioners adhere well to antibiotic prescribing guidelines. There are conditions for which there is a high potential for inappropriate prescribing. High variation between practices suggests room for improvement. Stricter implementation of prescribing guidelines may help improve prescribing practice. Alternatively, a practice-specific approach could be effective. The Dutch setting may be exemplary for international antibiotic prescribing practice.
绘制全科医生的抗生素处方行为图谱对于优化初级医疗中的抗生素使用以及减轻抗生素耐药性至关重要。
本研究的目的是检查荷兰全科医生对耳部和呼吸道症状及疾病处方指南的遵循情况。
对2018年至2021年荷兰电子健康记录进行横断面研究。根据专业处方指南，检查耳部和呼吸道症状及疾病的抗生素处方频率和类型。应用描述性统计和多水平逻辑回归分析。
分析了多达384家全科诊所的患者记录，涉及15种耳部疾病和27种呼吸道疾病。在15种耳部疾病中的11种（73%）以及27种呼吸道疾病中的17种（63%）中，超过95%的患者按照处方指南接受治疗。抗生素处方指南最有可能未被遵循的情况发生在急性中耳炎（31%-34%）、急性支气管炎/细支气管炎（26%-39%）和急性鼻窦炎（25%-34%）。其他几种呼吸道疾病的非适应证处方率高于10%。对于外耳道炎，开具了许多广谱抗生素，这种情况在呼吸道疾病中很少发生。全科诊所之间的处方频率和类型存在很大差异。
对于大多数疾病，荷兰全科医生很好地遵循了抗生素处方指南。存在一些处方不当可能性很高的疾病。诊所之间差异很大表明有改进空间。更严格地执行处方指南可能有助于改善处方行为。或者，采用针对具体诊所的方法可能会有效。荷兰的情况可能为国际抗生素处方行为提供范例。
