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Int. Rev. Allergol. Clin. Immunol. Family Med., 2015, XXI/1: 025-031 Maximize

Int. Rev. Allergol. Clin. Immunol. Family Med., 2015, XXI/1: 025-031

Title: The choice of antibiotics in respiratory tract infections by family physicians in north-eastern Poland 

Authors: Strumiło J, Chlabicz S, Pytel-Krolczuk B, Rogowska-Szadkowska D, Marcinowicz L, Litwiejko A, Milewska AJ

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05-01-2015

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SUMMARY IN POLISH & ENGLISH. FULL ARTICLE ONLY IN ENGLISH.

The choice of antibiotics in respiratory tract infections by family physicians in north-eastern Poland


Strumiło J1, Chlabicz S1, Pytel-Krolczuk B1, Rogowska-Szadkowska D1, Marcinowicz L1, Litwiejko A1, Milewska AJ2.

Medical University of Bialystok, Poland: 1Departament of Family Medicine and Community Nursing; 2Departament of Statistics and Medical Informatics, The Faculty of Health Sciences

Int. Rev. Allergol. Clin. Immunol. Family Med., 2015; Vol. 21, No. 1, 25

Respiratory tract infections are the leading cause of the patients visits in the ambulatory care and the most frequent cause of antibiotic prescribing in the primary health care. Family physicians could be a target of potential interventions in order to improve the quality of prescription and reduce the number of unnecessary antibiotic therapies, and consequently, to inhibit the increase of antibiotic resistance in the future.
The aim of the study
is to analyze family physicians decisions regarding antibiotic prescribing and how those decisions are coherent with the current Polish guidelines of respiratory tract infection (RTI) treatment.
Material and methods
. The study was carried out in the family medicine practices in the city of Bialystok. The method of direct observation was used in our study. During each visit of the patient with respiratory tract infection the observer (the family medicine resident) filled in the questionnaire. The questionnaire included patient’s data(age, gender), clinical symptoms, diagnosis, the kind of prescribed antibiotic and data about patient’s influence on prescription decision.
Results
. 50 family physicians were enrolled into the study and 1456 consultations of patients with respiratory tract infection symptoms were registered. In the case of as many as 55.15 % of patients antibiotic was prescribed. Predominant antibiotics prescribed by family physicians were amoxicillin and amoxicillin with clavulanic acid (prescribed in 17.51 and 11.68% of visits of patients with RTIs accordingly). Clarithromycin was prescribed in 9.2% of cases and cefuroxime in 5.56% of consultations. Penicillin V was prescribed solely in 0.56% of all consultations.
Conclusions
. The first choice antibiotic was amoxicillin, which is consistent with the current guidelines of antibiotics in respiratory infections. Moreover, the use of broad-spectrum antibiotic – macrolides and cephalosporins – was noticed. Penicillin V choice – the drug of choice for bacterial pharyngitis and tonsillitis – still remained marginal.

Key words: respiratory tract infections, family physicians, antibiotics, guidelines