"What they see is what you get": Prescribing antibiotics for respiratory tract infections in primary care: Do high prescribers diagnose differently? An analysis of German routine data

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Details zur Publikation

Autorinnen und Autoren: Hueber S, Kühlein T, Gerlach R, Tauscher M, Schedlbauer A
Zeitschrift: PLoS ONE
Jahr der Veröffentlichung: 2017
Band: 12
Heftnummer: 12
Seitenbereich: e0188521
ISSN: 1932-6203


Abstract


Characteristics of high and low prescribers of antibiotics in German primary care were analysed using population data. We aimed to evaluate differences in prescribing rates and factors being associated with high prescribing, and whether high prescribers made the diagnosis of perceived bacterial infections more often.Routine data were provided by the Bavarian Association of Statutory Health Insurance Physicians. Routine data are delivered by primary care practices on a quarterly basis. We analysed data from 2011 and 2012. Patients older than 15 years with respiratory tract infections consulting a primary care physician were selected (6.647 primary care practices). Patient and physician characteristics associated with high prescribing were identified using stepwise logistic regression.Mean prescribing rate of antibiotics was 24.9%. Prescribing rate for high prescribers was 43.5% compared to 8.5% for low prescribers. High prescribers made the diagnosis of perceived bacterial infections more often (Mhigh = 64.5%, Mlow = 45.2%). In the adjusted regression model, perceived bacterial infections were strongly associated with high prescribing (OR = 13.9, 95% CI [10.2, 18.8]). Treating patients with comorbidities was associated with lower prescribing of antibiotics (OR = 0.6, 95% CI [0.4, 0.8]). High prescribers had a higher practice volume, a higher degree of prescribing dominance, and were situated more often in deprived areas and in rural settings.Compared to findings of studies in other European countries, prescribing rates were low. There was a considerable difference between prescribing rates of high and low prescribers. Diagnostic labelling was the best predictor for high prescribing. Current guidelines recommend considering antibiotic treatment for patients with co-morbidities. In our study, treating a large number of high-risk patients was not associated with high prescribing.



FAU-Autorinnen und Autoren / FAU-Herausgeberinnen und Herausgeber

Hueber, Susann Dr. phil.
Allgemeinmedizinisches Institut
Kühlein, Thomas Prof. Dr.
Lehrstuhl für Allgemeinmedizin


Einrichtungen weiterer Autorinnen und Autoren

Kassenärztliche Vereinigung Bayerns (KVB)


Zitierweisen

APA:
Hueber, S., Kühlein, T., Gerlach, R., Tauscher, M., & Schedlbauer, A. (2017). "What they see is what you get": Prescribing antibiotics for respiratory tract infections in primary care: Do high prescribers diagnose differently? An analysis of German routine data. PLoS ONE, 12(12), e0188521. https://dx.doi.org/10.1371/journal.pone.0188521

MLA:
Hueber, Susann, et al. ""What they see is what you get": Prescribing antibiotics for respiratory tract infections in primary care: Do high prescribers diagnose differently? An analysis of German routine data." PLoS ONE 12.12 (2017): e0188521.

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Zuletzt aktualisiert 2018-08-10 um 08:30