Appropriateness of antibiotic prescribing in a primary care area: A cross-sectional study

Objective: To assess the profile of patients receiving antibiotics and the appropriateness of these prescriptions for the clinical conditions. Methods: Design: Cross-sectional study of prescription-indication. Setting: A primary health care area in Andalusia. Subjects: Patients assigned to primary care centres. Patients with antibiotic prescriptions during 2009 were selected by simple random sampling (confidence level: 95%, accuracy: 5%). Primary endpoint: appropriateness of antibiotics prescribing to recommendations included in local guidelines. Data were obtained through the billing computerised prescriptions system and medical histories. Results: Twenty-five per cent of the population area received antibiotics during 2009. The 1,266 patient samples showed the following characteristics: 57.9% were women, with a mean age of 41 (+/- 1) years. There were 39.3% pensioners. The percentage of appropriate antibiotic prescriptions was 19.9%, with no difference due to gender. Statistically significant differences were related to age, being those over 65 years the group of patients with the highest percentage of inappropriateness. The main reasons for inappropriateness were: no recording of the infectious process (44.5%), a wrong treatment duration (15.5%), and the use of an inadequate antibiotic (11.5%). Conclusion: There is a high level of inappropriateness in antibiotic prescribing in primary care. The high level of under-recording of diagnoses, mainly in elderly patients, followed by the use of wrong schedules, and the wrong type of antibiotics were the main reasons of inappropriateness. (C) 2013 Elsevier Espana, S.L. and Sociedad Espanola de Enfermedades Infecciosas y Microbiologia Clinica. All rights reserved.