Faculty Bibliography

AIM/OBJECTIVE:To assess change in general practitioner (GP) management of upper respiratory tract infections (URTIs) during a nationwide project to reduce antibiotic consumption in a half-decade (1998 to 2002-3). METHOD/METHODS:Telephone survey of 100 randomly selected Auckland GPs in 1998 and 2002-3. Sixty-five GPs were in both samples. RESULTS:A 69% response rate was recorded for an additional 35 GPs recruited in 2002-3. Of the 65 GPs interviewed at both periods, the number agreeing that most patients who consult for URTIs expect antibiotics decreased from 82% to 57%. Seventy-seven percent of GPs reported they were less likely to prescribe antibiotics, with over a quarter believing this change resulted from both GP and patient education. Common situations where GPs increased their antibiotic prescribing were patient request/expectation; smokers; older; or having sinusitis, purulent sputum, purulent nasal discharge, or imminent overseas travel. Thirty-nine percent of GPs reported an increasing use of delayed prescriptions over the half-decade. Reported use of amoxicillin clavulanate reduced from 21% to 4% (p<0.001). CONCLUSION/CONCLUSIONS:The GPs' response that they are less likely to prescribe antibiotics is consistent with the reduction in national antibiotic use. This may be related to the national campaign. The reduction may be a combination of combined GP and patient change.

AIMS/OBJECTIVE:To assess changes in public knowledge, attitudes, and reported behaviour of antibiotic use in the management of the common cold and to compare with results of a 1998 study. The context is a nationwide project to reduce the consumption of antibiotics. METHOD/METHODS:Cross-section survey: telephone interviews of random sample of consenting Auckland telephone subscribers aged over 15 years comparing 1998 and 2003 responses. RESULTS:A 55% response rate of eligible participants was recorded. No change was noted between 1998 and 2003 in public awareness that antibiotics are not helpful in treating viral infections (38%). However there was a significant reduction in those attending doctor for the common cold (24% to 15%). In 2003, patients were less likely to receive antibiotic prescription and more likely to receive a delayed prescription. CONCLUSIONS:The majority of general public still do not understand that the common cold does not need antibiotic treatment. The advertising campaign may have reduced doctor prescribing hence the reduction in antibiotic use from 1998 to 2003.