Which practice-related factors influence on the number of antibiotic prescriptions?
A study conducted in 98% of Danish general practice
Aabenhus et al. studied the practice-related factors that influence on the prescription rate in Danish general practices (GPs). 10% of GPs were identified as high prescribers who accounted for 15% of total antibiotic prescriptions. They found that lack of CRP (C-reactive protein) test and urinary culture and high use of Strep A throat test and urinary culture as well as busy practices (high number of consultant per 1000 patients) and low percentage of antibiotic prescription issued on a phone compared to with all prescriptions were associated with high prescribers. High prescribers were also more prone to prescribe critically important antibiotics like macrolides and fluoroquinolones. The 10% high prescribers group was responsible of 18% critically antibiotics prescriptions.
Correct and rational use of diagnostic tests have an essential role in correct antibiotic prescription. In the study, a significant proportion of high prescribers did not have access to CRP test. CRP test could reduce the number of antibiotic prescriptions when it is used correctly. Aabenhus et al. suggested that CRP test should be considered in the future interventions. They also pointed out that the entire general section should work together towards reducing the appropriate use of antibiotics.
Link to the abstract: https://www.ncbi.nlm.nih.gov/pubmed/?term=Identifying+practice-related+factors+for+highvolume+prescribers+of+antibiotics+in+Danish+general+practice
Aabenhus R et al. Identifying practice-related factors for high-volume prescribers of antibiotics in Danish general practice. J Antimicrob Chemother J Antimicrob Chemother. 2017 Apr 19. doi: 10.1093/jac/dkx115