Format

Send to

Choose Destination
Ann Clin Microbiol Antimicrob. 2018 Jun 9;17(1):26. doi: 10.1186/s12941-018-0278-5.

Infectious disease burden and antibiotic prescribing in primary care in Israel.

Author information

1
Clalit Research Institute & Chief Physician's Office, Clalit Health Services, Tel Aviv, Israel. Marcelolo@clalit.org.il.
2
School of Public Health, University of Haifa, Haifa, Israel. Marcelolo@clalit.org.il.
3
School of Public Health, University of Haifa, Haifa, Israel.
4
Rambam Medical Center, Haifa, Israel.
5
Clalit Research Institute & Chief Physician's Office, Clalit Health Services, Tel Aviv, Israel.
6
Ben-Gurion University of the Negev, Beer-Sheva, Israel.
7
Clalit Health Services, Community Medicine Division, Tel-Aviv, Israel.
8
Rappaport Faculty of Medicine, Technion, Haifa, Israel.
9
Clinical Microbiology Laboratory, The Baruch Padeh Medical Center Poriya, Tiberias, Israel.
10
The Faculty of Medicine in the Galilee, Bar Ilan University, Zefat, Israel.
11
Infectious Disease Unit, Poriya Medical Center, Tiberias, Israel.

Abstract

BACKGROUND:

Antibiotics are frequently prescribed at many of the visits to primary care clinics, often for conditions for which they provide no benefit, including viral respiratory tract infections.

OBJECTIVES:

The aim was to evaluate primary care visits due to infectious diseases, and to estimate antibiotic prescribing and antibiotic dispensing by pharmacies.

METHODS:

Diagnosis of infectious disease, antibiotic prescribing and dispensing data at the individual patient level were extracted for 2015 from Clalit Health Services' electronic medical records and linked to determine the condition for which the antimicrobial was prescribed.

RESULTS:

There were 6.6 million visits due to infections, representing 22% of all primary care visits. The most common events were upper respiratory tract infections (38%) and pharyngitis (10%). Highest prescription rates were for urinary tract infections (80%), otitis media (64%), pharyngitis (71%), sinusitis (63%), and lower respiratory tract infections (76%). The highest rates of undispensed prescriptions were for acute gastroenteritis, urinary tract infections, and pharyngitis (24, 23, and 16%, respectively).

CONCLUSIONS:

Infectious diseases constitute a heavy burden on primary care, with overprescribing of antibiotics. Intervention to reduce unwarranted antibiotic use is needed. In pediatric care, interventions should focus on better controlling antibiotic consumption and encouraging adherence to guidelines for upper respiratory tract infections, pharyngitis, and otitis media. In adults interventions should aim to monitor antibiotic prescribing for upper respiratory tract infections and improve adherence to guidelines for urinary tract infections.

KEYWORDS:

Antibiotics; Burden; Infectious diseases; Outpatients; Prescriptions; Primary care

PMID:
29885657
PMCID:
PMC5994243
DOI:
10.1186/s12941-018-0278-5
[Indexed for MEDLINE]
Free PMC Article

Supplemental Content

Full text links

Icon for BioMed Central Icon for PubMed Central
Loading ...
Support Center