Indication-based use of antimicrobials in Finnish primary health care: Description of a method for data collection and results of its application

Abstract

Objective - To collect population-based information on treatment of infections with antibiotics in PHC. Design - A questionnaire study for general practitioners (GPs). Setting - All health centres of Pirkanmaa Hospital District in Finland. Patients - Patients with any infection attending health centre during 1 week in November 1994. Main outcome measures - An infection diagnosis by the GP. Results - A total of 4150 questionnaires were received from 223 doctors. Respiratory tract infections comprised 80% of all infections. Of all patients 64% received antimicrobial treatment. Unspecified upper respiratory tract infections and pharyngitis were rarely treated with antimicrobials (10 and 21%, respectively), whereas patients with acute bronchitis received antibiotics as often (83%) as patients with otitis media (93%) or tonsillitis (86%). The most commonly prescribed substances were cephalosporins (19% of all antimicrobials), penicillin V (17%), and amoxycillin (17%). Half of the cephalosporin use could be regarded as overuse. Half of the sulphatrimethoprims were used for otitis media. A quarter of the patients expressed a desire to receive antibiotic treatment. Conclusion - The method was practical, inexpensive, and successful in giving such information, which is needed for supervising the rational use of antibiotics in primary health care.