Abstract
Antibiotic consumption varies greatly between Norwegian municipalities. We examine whether this variation is associated with inhabitants’ consultation rates or general practitioners’ (GP) prescription rates. Our study comprises consultations and antibiotic prescriptions for respiratory tract infections (RTIs) in general practice in all Norwegian municipalities with over 5000 inhabitants in 2014. Data was collected from The Norwegian Prescription Database, The Directorate of Health’s system for control and payment of health reimbursements registry and Norway Statistics. Consultation rates and prescription rates were categorised in age- and gender specific quintiles and the effect on antibiotic consumption was analysed using a Poisson regression model. We found that inhabitants with RTIs received 42% more prescriptions if they belonged to a municipality with high consultation rates compared to low consultation rates [incidence rate ratio (IRR) 1.42 (95% CI 1.41–1.44)] and 48% more prescriptions if they belonged to a municipality with high prescription rates versus low prescription rates [IRR 1.48 (95% KI 1.47–1.50)]. Our results demonstrate that inhabitants’ consultation rates and GPs’ prescription rates have about equal impact on the number of RTI antibiotics prescribed at municipality level. These findings highlight the importance of interventions targeting patients as well as doctors in efforts to reduce unnecessary antibiotic consumption.
Highlights
Antibiotics are an integral part of modern health care
Our results demonstrate that inhabitants’ consultation rates and general practitioner (GP)’ prescription rates have about equal impact on the number of respiratory tract infections (RTIs) antibiotics prescribed at municipality level
The aim of this study is to investigate to what degree geographic variations in antibiotic consumption for RTIs is associated with differences in inhabitants’ health seeking behaviour and GPs’ prescription behaviour
Summary
Antibiotics are an integral part of modern health care. The use of antibiotics, especially wide spectrum antibiotics, increases the risk of antimicrobial resistance both at national and local levels [1,2].Scandinavian countries still have relatively low levels of antimicrobial resistance but this situation is threatened by an increasing relative use of broad spectrum antibiotics and import of resistant bacteria from abroad [3].All inhabitants in Norway are entitled to a general practitioner (GP). Antibiotics are an integral part of modern health care. The use of antibiotics, especially wide spectrum antibiotics, increases the risk of antimicrobial resistance both at national and local levels [1,2]. Scandinavian countries still have relatively low levels of antimicrobial resistance but this situation is threatened by an increasing relative use of broad spectrum antibiotics and import of resistant bacteria from abroad [3]. All inhabitants in Norway are entitled to a general practitioner (GP). GP offices, alongside accident and emergency units (A&Es), nursing homes, child health clinics and school health services make up most of Norwegian primary care. Most A&Es offer access 24 h a day year-round. Some GP offices offer appointments in the evenings on selected week days. Our study includes consultations conducted after hours and on weekends
Sign-in/Register to view highlights & summary Sign-in/Register to access full text options 
Free) 
Talk to us
Join us for a 30 min session where you can share your feedback and ask us any queries you have
Schedule a call
