Antibiotic use for upper respiratory tract infections before and after a education campaign as reported by general practitioners in New Zealand

Abstract

Aim: To assess change in general practitioner (GP) management of upper respiratory tract infections (URTIs) during a nationwide project to reduce antibiotic consumption in a half-decade (1998 to 2002-3).

Method: Telephone survey of 100 randomly selected Auckland GPs in 1998 and 2002-3. Sixty-five GPs were in both samples.

Results: A 69% response rate was recorded for an additional 35 GPs recruited in 2002-3. Of the 65 GPs interviewed at both periods, the number agreeing that most patients who consult for URTIs expect antibiotics decreased from 82% to 57%. Seventy-seven percent of GPs reported they were less likely to prescribe antibiotics, with over a quarter believing this change resulted from both GP and patient education. Common situations where GPs increased their antibiotic prescribing were patient request/expectation; smokers; older; or having sinusitis, purulent sputum, purulent nasal discharge, or imminent overseas travel. Thirty-nine percent of GPs reported an increasing use of delayed prescriptions over the half-decade. Reported use of amoxicillin clavulanate reduced from 21% to 4% (p<0.001).

Conclusion: The GPs' response that they are less likely to prescribe antibiotics is consistent with the reduction in national antibiotic use. This may be related to the national campaign. The reduction may be a combination of combined GP and patient change.