Biomedical subjects

Sigvard Mölstad

Publications and source records attributed to Sigvard Mölstad.

25 records · Page 2Linked to original sources

PubMed2002

Antibiotic prescription rates vary markedly between 13 European countries.

There is a lack of data on antibiotic utilization in most European countries. In this study, information about the number of antibiotic prescriptions was obtained for Austria, Belgium, Finland, France, Germany, Greece, Italy, The Netherlands, Portugal, Spain and the UK from the Institute for Medical Statistics Health Global Services in the UK. For Denmark and Sweden the information was obtained from the Danish Medicines Agency (Laegemiddelstyrelsen) and the National Corporation of Swedish Pharmacies (Apoteket AB), respectively. Between 1994 and 1997 the number of prescriptions per 1,000 inhabitants increased in France and Greece whilst Portugal, Spain and Sweden reported a decrease. In 1997, Greece (1,350), Spain (1,320) and Belgium (1,070) had the highest numbers of antibiotic prescriptions per 1,000 inhabitants in the Anatomical Therapeutic Chemical classification system for drugs group J01 while The Netherlands (390), Sweden (460) and Austria (480) had the lowest. The most common antibiotic drug was extended-spectrum penicillin in 6/13 countries, macrolides in Austria, Finland, Germany and Italy, phenoxymethylpenicillin in Denmark and Sweden and cephalosporins in Greece. The variation in the number of antibiotic prescriptions per 1,000 inhabitants between the 13 European countries was substantial in terms of both total use and use of different antibiotics.

Anti-Bacterial Agents↗

PubMed2002

Antibiotic prescribing in outpatients: a 1-week diagnosis-prescribing study in 5 counties in Sweden.

A diagnosis-antibiotic prescribing study initiated by the Swedish Strategic Programme for the Rational Use of Antimicrobial Agents and Surveillance of Resistance was performed in 5 counties in Sweden (total 1,290,000 inhabitants) during 1 week in November 2000. The aims of the study were to analyse diagnoses and antibiotics prescribed for outpatients and to appraise the feasibility of the data collection method. Physicians in primary care and departments of ENT, paediatrics and infectious diseases completed a questionnaire for each patient with an infectious disease complaint, including information about age, sex, diagnosis, diagnostic methods used and treatment. When an antibiotic was prescribed, the type and duration of treatment were noted. A total of 7,071 forms were returned, of which 7,029 included information on diagnosis; infections of the respiratory tract, urinary tract and the skin or soft tissues were responsible for 70%, 14% and 10% of the visits, respectively. Antibiotics were prescribed in 59% of all cases and phenoxymethylpenicillin was the most commonly prescribed antibiotic. Of the forms returned, 94% emanated from primary care centres. In conclusion, this study provides information on the treatment pattern associated with various diagnoses and the pattern of use of various antibiotics. Such a study is relatively simple to perform and entails only a small extra workload for the participants.

Adolescent↗

PubMed2002

Upper respiratory tract infections in general practice: diagnosis, antibiotic prescribing, duration of symptoms and use of diagnostic tests.

A diagnosis/antibiotic prescribing study was performed in 5 counties in Sweden for 1 week in November 2000. As part of this study, the characteristics and clinical management of patients with upper respiratory tract infections (n = 2899) in primary care were analyzed. Almost half of the patients were aged < 15 y and one-fifth of the patients consulted out of hours. Of all patients seeking primary care for upper respiratory tract infections, 56.0% were prescribed an antibiotic. Almost all patients who were given the diagnoses streptococcal tonsillitis, acute otitis media or acute sinusitis were prescribed antibiotics, compared to 10% of patients with common cold or acute pharyngitis. The most frequently prescribed antibiotic was penicillin V (79.2%) and this was even more pronounced out of hours, when the diagnoses otitis media and streptococcal tonsillitis were more frequently used. In patients with common cold and acute pharyngitis, the percentage who received antibiotics increased with increasing length of symptoms and increasing CRP levels. In patients with acute pharyngitis or streptococcal tonsillitis, antibiotics were prescribed less frequently provided streptococcal tests were performed. The management of patients with upper respiratory tract infections in general practice seems to be in good agreement with current Swedish guidelines. However, the study indicates some areas for improvement. The diagnosis of acute sinusitis seems to have been overestimated and used only to justify antibiotic treatment.

Acute Disease↗

PubMed2002

Differences in antibiotic prescribing patterns between general practitioners in Scandinavia: a questionnaire study.

There has been a dramatic increase in the prevalence of antibiotic-resistant bacteria worldwide. In the Scandinavian countries at least 90% of total antibiotic use relates to outpatients and therefore it has become increasingly important to know the antibiotic prescription pattern of general practitioners (GPs) in order to implement and monitor changes in antibiotic prescribing. The aim of the present study was to evaluate the prescription patterns of GPs in Denmark, Norway and Sweden. In order to achieve a reasonable comparison, a questionnaire consisting of 7 case reports concerning upper and lower respiratory tract infections, urinary tract infections and skin and soft tissue infections was sent to 1,000 GPs in the 3 countries. In general, the guidelines for the treatment of bacterial infections in the individual countries were followed by the responders. In all 3 countries, penicillin V was still the drug most frequently used in upper and lower respiratory tract infections. The greatest difference in prescribing patterns among the countries was seen in the treatment of urinary tract infections, recurrent pharyngeal tonsillitis, acute otitis media and acute exacerbation of chronic bronchitis. There were also differences in the dosing regimens, length of treatment and use of diagnostic techniques.

Acute Disease↗

PubMed2002

Asymptomatic bacteriuria in a population of elderly in municipal institutional care.

OBJECTIVE: To study the prevalence of asymptomatic bacteriuria (ABU) among patients in municipal institutional care for the elderly. DESIGN: A cross-sectional study. SETTING: Three different municipalities in southern Sweden. SUBJECTS: 237 elderly people in municipal institutional care. MAIN OUTCOME MEASURES: Positive urine cultures. RESULTS: In the first culture, the prevalence of bacteriuria was 42%; 47% for women and 30% for men. ABU occurred in 23% of the patients; in 26% of women and in 16% of men. Urinary incontinence was more common among patients with ABU. CONCLUSION: Bacteriuria is common among elderly people living in institutions. This should be borne in mind when patents in institutional care for the elderly have fever. Other differential diagnoses than urinary tract infection should be considered before antibiotic treatment is given.

Aged↗

PubMed2002

The more time spent on listening, the less time spent on prescribing antibiotics in general practice.

OBJECTIVE: To analyse the variation between primary care centres (PCCs) with regard to prescribing antibiotics and to investigate whether the variation can be explained by factors related to patient satisfaction and to socio-demographic characteristics of the populations in the catchment areas of the PCCs. METHODS: The frequency of prescription of antibiotics by GPs at the PCCs was used as the dependent variable in a multivariate regression analysis. Questionnaire data for patient satisfaction and register data for socio-demographic characteristics were used as explanatory variables. The study was set in a county in south-east Sweden, and 6734 patients consulting GPs at 39 out of the 41 PCCs in the county participated. Variables correlating with the frequency of antibiotics prescription at PCC level and with patient satisfaction were the main outcome measures. RESULTS: A seven-fold variation in the extent of the prescription of antibiotics between the PCCs was observed. In the multivariate analysis, a high antibiotic prescription rate relates to high overall patient satisfaction with GP consultation as well as to the share of males in the listed population but to low satisfaction with the time spent by the GP on listening to the patient. CONCLUSION: A high frequency of prescription of antibiotics at a PCC may reflect a general disposition among GPs to give priority to maintaining good relations with the patients. However, a low level of prescription may be consistent with patient satisfaction if more time is spent on listening to and informing the patients. Thus more time spent on listening to the patients may reduce the prescription of antibiotics without reducing patient satisfaction.

Anti-Bacterial Agents↗

PubMed2002

A European study on the relationship between antimicrobial use and antimicrobial resistance.

In Europe, antimicrobial resistance has been monitored since 1998 by the European Antimicrobial Resistance Surveillance System (EARSS). We examined the relationship between penicillin nonsusceptibility of invasive isolates of Streptococcus pneumoniae and antibiotic sales. Information was collected on 1998-99 resistance data for invasive isolates of S. pneumoniae to penicillin, based on surveillance data from EARSS and on outpatient sales during 1997 for beta-lactam antibiotics and macrolides. Our results show that in Europe antimicrobial resistance of S. pneumoniae to penicillin is correlated with use of beta-lactam antibiotics and macrolides.

Anti-Bacterial Agents↗