Improving the Prescribing of Antimicrobial Drugs in Primary Health Care: the Effect of Being Members of a Scientific Society

Unnecessary use of antibiotics plays an important role in increasing bacterial resistance and medical costs as well as in the risk of drug-related adverse events [1]. The most frequent indication for antibiotic prescription in Europe is respiratory tract infections (RTI) [2]. Clinical signs and symptoms are unreliable for distinguishing viral from bacterial RTI [3]. Diagnostic uncertainty increases the likelihood of inappropriate antibiotic prescription and, when in doubt, general practitioners (GP) opt for antibiotic prescription. Compared to other European countries, Spain has historically had a high outpatient antimicrobial consumption rate [4]. We presented an abstract in WONCA 2000 aimed at knowing if GPs who are members of task force groups on the rational use of antibiotics prescribe antibiotics more appropriately than GPs who are not involved in these study groups. The overall consumption of antibacterial drugs in 1997 was lower among the six GPs who were members of a task force compared with the mean prescription of all the GPs in Catalonia (10.1 DID vs. 14.8 DID, respectively). In addition, the former GPs prescribed more penicillins and fewer macrolides and quinolones than their counterparts. A prospective non-randomised controlled before-after study was performed in primary care clinics in 2008 and 2009. This study constituted part of the Happy Audit project, a study financed by the European Commission [5]. A total of 281 FDs throughout Spain participated in this study, with the inclusion of FDs in nine Autonomous Communities. Some of these GPs were members of study groups on the rational use of antibiotics in each of these areas, belonging to the Societies of Family Medicine. We wished to know if the antibiotic prescription of these GPs significantly varies from the remaining GPs in terms of the total amount of antibiotics prescribed for RTIs and the type of antibiotics used.