Arens Birgit, L'hoest Helmut, Wolf Alissa, Hennig Beata, Marschall Ursula, Nachtigall Irit
Kompetenz-Centrum Qualitätssicherung, Medizinischer Dienst Baden-Württemberg, Lahr, Germany.
Barmer Institut für Gesundheitssystemforschung, Medizin und Versorgungsforschung, Berlin, Germany.
GMS Infect Dis. 2025 May 27;13:Doc01. doi: 10.3205/id000091. eCollection 2025.
Acute upper respiratory tract infections (URTIs) are frequent causes of medical treatment by general practitioners (GPs). In general, these are viral and self-limiting illnesses, but antibiotics are prescribed. In Germany, fluoroquinolones are not authorised for the indications pharyngitis, laryngitis, tonsillitis and acute bronchitis due to possible serious side effects. This analysis looks at fluoroquinolone prescriptions for URTI by GPs in 2022.
Frequency of fluoroquinolone prescriptions were analysed at case level and regionally using administrative insurance data from the German health insurance company BARMER. We included patients treated in GP practices without relevant concomitant diseases.
In 2022, 25% (1,197,568/4,720,786) of insured persons with upper respiratory tract infections (URTI) were prescribed antibiotics. After excluding comorbidities and other risk factors such as previous hospitalisation, the prescription rate for uncomplicated URTIs was calculated to be 6% (80,786/1,365,646). Fluoroquinolones were given in 2.4% of antibiotic prescriptions (1,951/80,786). Nationwide, 3.7% of the GPs prescribed fluoroquinolones, most frequently in the region Brandenburg with 6.6% (74/1,121).
This analysis showed that fluoroquinolones are still prescribed for uncomplicated URTI, which must be considered as alarming regarding the nature of the disease and the unfavourable risk-benefit profiles. There were clear regional differences in fluoroquinolone prescribing, indicating potential for improvement in the use of reserve antibiotics for uncomplicated upper respiratory tract infections.
急性上呼吸道感染（URTIs）是全科医生（GPs）进行医疗诊治的常见病因。一般来说，这些是病毒性的自限性疾病，但仍会开具抗生素。在德国，由于可能存在严重副作用，氟喹诺酮类药物未被批准用于咽炎、喉炎、扁桃体炎和急性支气管炎的适应症。本分析着眼于2022年全科医生针对上呼吸道感染开具氟喹诺酮类药物的处方情况。
利用德国健康保险公司BARMER的行政保险数据，在病例层面和区域层面分析氟喹诺酮类药物处方的频率。我们纳入了在全科医生诊所接受治疗且无相关合并症的患者。
2022年，患有上呼吸道感染（URTIs）的参保人员中有25%（1,197,568/4,720,786）被开具了抗生素。排除合并症和其他风险因素（如既往住院史）后，单纯性上呼吸道感染的处方率经计算为6%（80,786/1,365,646）。在抗生素处方中，2.4%（1,951/80,786）使用了氟喹诺酮类药物。在全国范围内，3.7%的全科医生开具了氟喹诺酮类药物，其中最频繁的是勃兰登堡地区，为6.6%（74/1,121）。
该分析表明，对于单纯性上呼吸道感染仍会开具氟喹诺酮类药物，就疾病性质和不利的风险效益比而言，这必须被视为令人担忧的情况。氟喹诺酮类药物的处方存在明显的地区差异，这表明在单纯性上呼吸道感染中使用储备抗生素方面有改进的潜力。
