Respiratory tract infections in primary health care: Prevalence and antibiotic prescribing in a primary care practice during one year

Abstract

Summary Background. Respiratory tract infections (RTIs) are one of the main reasons for primary health care (PHC) visits. In spite of the predominant viral aetiology of RTIs, antibiotherapy is common, especially in outpatient clinics. Objectives. The aim was to analyse the prevalence of different RTIs and prescription of antibiotics in the adult population of an urban PHC practice in the north of Poland. Material and methods. A retrospective analysis of the medical files of 1,735 visits of 1,354 patients with a diagnosis of RTI between January and December 2014 was carried out. Results. The results include 1,112 (64.1%) visits by females and 623 (35.9%) visits by males. The mean age of patients was 49.5 ± 19.8 years of age. An unspecified infection was diagnosed in 59.7% of the visits and common cold in 13.6%. Less than 1% of the annual visits took place in summer, 25.82% in December. Antibiotherapy was prescribed for 68% of patients. Azithromycin (25.2%), amoxicillin with clavulanic acid (21.8%), amoxicillin (19.5%) and cefuroxime (10%) were the most commonly used for 76.5% of patients prescribed with antibiotics. From the penicillin group, only amoxicillin or amoxicillin with clavulanic acid were prescribed. Conclusions. 1. More than half of RTIs were diagnosed as ‘unspecified infection’. This indicates a need to improve the precision of the diagnostic process. 2. The huge seasonal variation in RTIs determines the need to optimize the PHC work system. 3. Notwithstanding the growing awareness of the dangers of antibiotic overuse, antibiotics were prescribed for 2/3 of patients.