Outpatient Antibiotic Prescription in the South of Portugal

Background: Antibiotic abuse and misuse are recognized as important determinants for bacterial antibiotic resistance. Although there are frequent calls to stop the unnecessary use of antibiotics, both consumption and resistance are escalating over the world. Objective: To assess the antibiotic prescription and its determinants in the Algarve, for different infectious diseases in Primary Care. Method: A Drug Use Study (Prescription-Indication Study) was performed in a convenience sample of 70 general practitioners (GPs) working in the Algarve (Portugal). During the study period each GP consecutively selected 20 patients with an antibiotic prescription for systemic use, characterizing their clinical and therapeutic profiles. Results: About 81% (57/70) of the invited GPs returned the requested data. A total of 925 patients were included in the study, 40% of them male. Patients’ mean age was 41.4 years (range: 1 to 94; SD=24.14). Respiratory (50.5%) and urinary tract infections (29.8%) were the infectious conditions more frequently treated, accounting for 80.3% of the total. Penicillins were the antibiotics most prescribed (43.7%), followed by macrolides (20.15%) and quinolones (19.3%), the last two preferably prescribed by older GPs. For respiratory infections, younger GPs prescribed penicillins more frequently (62.1%) than other GPs. While treating the same infections, female GPs prescribed significantly more macrolides (40.5%) than males (29.6%). Conclusion: Considering the costs, side effects and growth of bacterial resistance, it is important to improve antibiotic prescribing as much as possible. Developing effective interventions to reduce inappropriate antibiotic prescribing will require a clear understanding of the predictors that influence the prescribing behaviour.