Patient Demographic and Clinician Factors in Antibiotic Prescribing for Upper Respiratory Tract Infections in the Australian Capital Territory from 2006-2015Correspondence Address :
Professor Abdel-Latif Mohamed,
Department of Neonatology, Centenary Hospital for Women and Children; The Australian National University Medical School;
PO Box-11, Woden ACT-2606, Australia, Woden, ACT, Australia.
Introduction: National antibiotic stewardship programs aim to mitigate rising antimicrobial resistance and associated healthcare costs by promoting safe and appropriate antibiotic prescribing.
Aim: This study aimed to analyse patient and clinician demographic factors that may influence antibiotic prescribing for Upper Respiratory Tract Infections (URTIs). Trends in antibiotic prescribing patterns were also analysed over the study period.
Materials and Methods: This retrospective cross-sectional study analysed data from the Australian National University Medical School Clinical Audit Project database, comprising data collected by students during patient encounters over a two week period each April-May between 2006 and 2015 (excluding 2013). Data was collected via standardised survey in multiple healthcare settings and locations in the Australian Capital Territory (ACT) and Southeast New South Wales. (NSW) URTI diagnosis and symptomatology were defined using the International Classification of Disease (ICD-10) and International Classification of Primary Care, version 2 PLUS (ICPC-2+) criteria.
Results: URTI accounted for 5.6% (n=698) of total patient encounters (n=12,468), and of these, 42.7% (n=289) were prescribed an antibiotic intervention. Antibiotics were significantly more likely to be prescribed in the hospital setting (44.2%; n=237) compared to community GP (32.1%; n=52; p<0.05) and for patients presenting with localised symptoms (65.9%; n=109) compared to generalised symptoms (33.7%; n=122; p<0.01). No significant association was observed for age, rurality, patient gender, clinical gender or Indigenous status. The most frequently prescribed antibiotic was penicillin (67.8%; n=196). Over the decade of study, antibiotic prescribing for URTIs showed decreasing trend both overall (R2=0.204) and with respect to all demographic factors assessed.
Conclusion: This study supports the effectiveness to-date of antibiotic stewardship programs in Australia. While continued efforts are required to further mitigate antibiotic resistance, this study suggests target areas may include improving clinician resistance to patient demand for antibiotics, and increasing confidence in prescribing for special populations such as Indigenous peoples and the extremes of age.
Resistance, Upper respiratory tract infections
Hannah Glenn, Justin Friedman, Alexander A. Borecki, Camilla Bradshaw, Nicolas Grandjean-Thomsen, Harrison Pickup, et al.. PATIENT DEMOGRAPHIC AND CLINICIAN FACTORS IN ANTIBIOTIC PRESCRIBING FOR UPPER RESPIRATORY TRACT INFECTIONS IN THE AUSTRALIAN CAPITAL TERRITORY FROM 2006-2015. Journal of Clinical and Diagnostic Research [serial online] 2017 August [cited: 2017 Aug 20 ]; 11:FC01-FC05. Available from
Date of Submission: Nov 19, 2016
Date of Peer Review: Dec 27, 2016
Date of Acceptance: Apr 26, 2017
Date of Publishing: Aug 01, 2017
Financial OR OTHER COMPETING INTERESTS: None.
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