Antibiotic prescribing patterns and hospital admissions with respiratory and urinary tract infections

Objective To explore the relationship between antibiotic prescribing indicators for assessing the prescribing quality of general practitioners (GPs) and populations' health outcome indicators. Design Descriptive cross-sectional study. Setting Aljarafe Primary Health Care Area ( population 321,034) under the administrative jurisdiction of the Andalusian Public Health Care Service, Spain. In total, 162 GPs, representing 95.29% of the total number of GPs in the study area, were included in the analysis. Methods Antibiotic prescribing indicators based on clinical evidence and recommendations from local resistance patterns were chosen by the consensus group technique. Hospital admissions due to respiratory tract and urinary infections in the three hospitals of the study area were recorded. Multiple regression analysis was carried out to determine the relationship between community prescribing of antibiotics and hospital admissions due to serious complications from respiratory and urinary infections. Results The higher prescribing of antibiotics adjusted for patients and working days was associated with a significantly higher number of adjusted hospital admissions due complications arising from respiratory and urinary infections (p< 0.001) (R-2=0.142). This relationship was not found for indicators based on the relative prescribing of recommended first-line versus second and third-line antibiotics. There were fewer patients of women GPs admitted to hospitals (p= 0.021). Conclusions Our findings show a statistically significant relationship-at the GPs level-between the quantitative antibiotic prescribing rate and standardized hospital admissions due to complications arising from respiratory and urinary infections of the assisted patients. Strategies should be addressed to reduce unnecessary antibiotic prescribing in primary care.