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Antibiotics Overprescribed for Respiratory Symptoms

Study reports association between diagnostic labeling and receipt of antibiotics

FRIDAY, Sept. 28 (HealthDay News) -- General practitioners label most acute respiratory tract episodes as infections and overprescribe antibiotics as a result, rather than using evidence-based criteria, according to a report published online Sept. 20 in BMC Family Practice.

Huug J. van Duijn, from University Medical Center in Utrecht, the Netherlands, and colleagues analyzed data from 163 Dutch general practitioners serving 359,625 patients, regarding their antibiotic prescribing habits over a 12-month period.

There were 236.9 acute respiratory tract episodes per 1,000 patients, the researchers found. The doctors labeled about 70 percent of these as infections and prescribed antibiotics in 41 percent of episodes. Antibiotic volumes for acute respiratory tract episodes were independently determined by several factors, including a higher incidence of acute respiratory tract episodes and a stronger tendency to label episodes as infections.

"Diagnostic labeling is a relevant factor in general practitioners' antibiotic prescribing independent from the incidence of acute respiratory tract episodes," van Duijn and colleagues conclude. "Therefore, quality assurance programs and postgraduate courses should emphasize to use evidence-based prognostic criteria (e.g. chronic respiratory co-morbidity and old age) as an indication to prescribe antibiotics instead of single inflammation signs or diagnostic labels."

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