Abstract
Background: National guidelines are important instruments in reducing inappropriate antibiotic prescriptions. Low adherence to guidelines is an acknowledged problem that needs to be addressed.Method: We evaluated established characteristics for guidelines in the guidelines for lower respiratory tract infection, acute otitis media and pharyngotonsillitis in primary care. We studied how doctors used these guidelines by analysing interviews with 29 general practitioners (GPs) in Sweden.Results: We found important between-guidelines differences, which we believe affects adherence. The GPs reported persistent preconceptions about diagnosis and treatment, which we believe reduces their adherence to the guidelines.Conclusion: To increase adherence, it is important to consider doctors’ preconceptions when creating new guidelines.
Highlights
National guidelines are important instruments in reducing inappropriate antibiotic prescriptions
Primary care is an important target for reducing antibiotic consumption, since 90% of antibiotics used in Sweden are prescribed in outpatient care, of which about 60% are prescribed by general practitioners (GPs)
Large variations in antibiotic prescriptions between countries, counties, primary health care centres (PHCCs) and prescribers suggests that antibiotics are overprescribed [4,5,6,7,8]
Summary
National guidelines are important instruments in reducing inappropriate antibiotic prescriptions. Results: We found important between-guidelines differences, which we believe affects adherence. The GPs reported persistent preconceptions about diagnosis and treatment, which we believe reduces their adherence to the guidelines. Primary care is an important target for reducing antibiotic consumption, since 90% of antibiotics used in Sweden are prescribed in outpatient care, of which about 60% are prescribed by general practitioners (GPs). Large variations in antibiotic prescriptions between countries, counties, primary health care centres (PHCCs) and prescribers suggests that antibiotics are overprescribed [4,5,6,7,8]. As part of the Swedish strategy to curb antibiotic use, national evidence-based guidelines for different infectious diagnoses have been developed by the Public Health Agency of Sweden and the Swedish Strategic
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