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The European Journal of Public Health Advance Access published online on June 7, 2005
The European Journal of Public Health, doi:10.1093/eurpub/cki080
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© The Author 2005. Published by Oxford University Press on behalf of the European Public Health Association. All rights reserved
Received January 17, 2002
Accepted January 19, 2004

Article

Antibiotic prescription in primary health care: clinical and economic perspectives (Catalonia, Spain)

Josefina Caminal 1* and Joan Rovira 2

1 1 Universitat Autònoma de Barcelona, Catalonia, Spain
2 2 Human Development Network, World Bank, Washington, DC, USA

* To whom correspondence should be addressed.
Josefina Caminal, E-mail: josefina.caminal{at}uab.es


  Abstract

Objective: To quantify clinical inappropriateness of antibiotic prescription and its costs in primary health care. Methods: 2470 cases of infectious disease during 1998 were analysed. Results: Of all cases, 69.9% did not require antibiotic treatment. Global clinical inappropriateness amounted to 43.7%, rising to 56.7% with the introduction of economic criteria. Treatment unnecessary but antibiotic provided (27.9%) represented the most important category. Costs of inappropriateness reached 68.4% of the estimated total cost. Conclusion: Appropriate antibiotic use should be focused on reducing antibiotic prescription when not indicated and restrainting the use of penicillins maintaining restrictive and adequate health policies, and also achieving co-responsibility from the general population.

Keywords: antibiotic prescription; clinical inappropriateness; costs of inappropriateness; primary health care.
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