A new tool to reduce antibiotic prescriptions?

October 02, 2000

Three years ago, a national consensus conference on antibiotic resistance recommended that the number of antimicrobial prescriptions written in Canada be reduced "by 25% within 3 years by focusing on community-acquired respiratory infection."

In this issue of Canadian Medical Association Journal, Dr. Warren McIsaac and colleagues evaluate their previously published clinical score for the management of infections of the upper respiratory tract accompanied by sore throat and the potential impact of the clinical score on the prescribing of antibiotics in community-based medicine. The study is considered important because of the growing problem caused by antibiotic resistance.

The authors surveyed 97 family physicians in 49 Ontario communities who assessed children and adults with a new infection of the upper respiratory tract and compared their prescribing decisions with previously published results for patients seen at an academic family medicine centre. The authors also compared the physicians' prescribing practices and their recommendations for obtaining throat swabs with score-based recommendations.

The authors report that physicians prescribed antibiotics in 173 out of 619 cases (27.9%) and of the 173 prescriptions, 109 (63%) were given to patients with culture-negative results for group A Streptococcus. They add that using the clinical score to determine management would have reduced prescriptions to culture-negative patients by 63.7% and overall antibiotic prescriptions by 52.3%. The finding is considered important because of the growing problem of antibiotic resistance "This approach could substantially reduce unnecessary prescribing of antibiotics by family physicians and is consistent with national recommendations for limiting antibiotic resistance," conclude the authors.
The validity of a sore throat score in family practice - W.J. McIsaac et al.

Contact: Dr. Warren McIsaac, Family Medicine Centre, Mount Sinai Hospital, Toronto

Canadian Medical Association Journal

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