Prescriptions of antibiotics for children - Prescribing habits of district, hospital, and private physicians

Objective - To study how different categories of physicians prescribe antibiotics for children with respiratory tract infections. Design - Prescriptions of antibiotics for children less than 15 years of age were registered at the pharmacies in the municipality of Vaxjo during the month of March from 1990 to 1993. Subjects - Three categories of physicians were studied: district, hospital, and private. They made 3047 prescriptions for one of the following groups of antibiotics: penicillin V, ampicillin derivatives, erythromycin or other macrolides, and peroral cephalosporins. Main outcome measures - The choice and cost of drug for each physician category. The proportion of prescriptions made by district physicians in relation to distance from town centre and doctor density in local health centre. Results - The district physicians used penicillin V more frequently (70% of prescriptions) than the other categories of physicians (50% and 19%), but ampicillin derivatives and cephalosporins less frequently. District physicians had a lower cost per prescription in general (SEK 92) than hospital physicians (SEK 110) and private physicians (SEK 175). The proportion of prescriptions issued by district physicians increased with increasing distance from the town centre and with higher doctor density in the local health centre. Conclusion - District physicians use more penicillin V, and have a lower cost per prescription, than other physicians. This might be due to differing infectious disease panoramas, but can also reflect differences in practice and attitudes.