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Fossum GH, Gjelstad S, Kværner KJ, et al. Prescribing antibiotics when the stakes are higher - do GPs prescribe less when patients are pregnant? A retrospective observational study. BJGP Open. 2018;2(2):bjgpopen18X101505doi: 10.3399/bjgpopen18X101505.
Fossum, G. H., Gjelstad, S., Kværner, K. J., & Lindbaek, M. (2018). Prescribing antibiotics when the stakes are higher - do GPs prescribe less when patients are pregnant? A retrospective observational study. BJGP open, 2(2), bjgpopen18X101505. https://doi.org/10.3399/bjgpopen18X101505
Fossum, Guro Haugen, et al. "Prescribing antibiotics when the stakes are higher - do GPs prescribe less when patients are pregnant? A retrospective observational study." BJGP open vol. 2,2 (2018): bjgpopen18X101505. doi: https://doi.org/10.3399/bjgpopen18X101505
Fossum GH, Gjelstad S, Kværner KJ, Lindbaek M. Prescribing antibiotics when the stakes are higher - do GPs prescribe less when patients are pregnant? A retrospective observational study. BJGP Open. 2018 May 02;2(2):bjgpopen18X101505. doi: 10.3399/bjgpopen18X101505. eCollection 2018 Jul. PMID: 30564716; PMCID: PMC6184091.
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BJGP Open. 2018 May 02;2(2):bjgpopen18X101505. doi: 10.3399/bjgpopen18X101505. eCollection 2018 Jul.

Prescribing antibiotics when the stakes are higher - do GPs prescribe less when patients are pregnant? A retrospective observational study.

BJGP open

Guro Haugen Fossum, Svein Gjelstad, Kari J Kværner, Morten Lindbaek

Affiliations

  1. PhD Student, Department of General Practice, Antibiotic Center for Primary Care, Institute of Health and Society, University of Oslo, Oslo, Norway.
  2. Associate Professor, Department of General Practice, Antibiotic Center for Primary Care, Institute of Health and Society, University of Oslo, Oslo, Norway.
  3. Professor, C3 Centre for Connected Care, Oslo University Hospital and BI Norwegian Business School, Oslo, Norway.
  4. Professor, Department of General Practice, Antibiotic Center for Primary Care, Institute of Health and Society, University of Oslo, Oslo, Norway.

PMID: 30564716 PMCID: PMC6184091 DOI: 10.3399/bjgpopen18X101505

Abstract

BACKGROUND: Most oral antibiotics are prescribed by GPs, and they are therefore the most important influencers with regard to improving antibiotic prescription patterns. Although GPs' prescription patterns in general are well-studied, little is known about antibiotic prescription patterns in pregnancy.

AIM: To study GPs' antibiotic prescriptions in respiratory tract infections (RTIs) during pregnancy, and assess differences, if any, between pregnant and non-pregnant patients.

DESIGN & SETTING: Retrospective observational study combining prescription data from the Norwegian Peer Academic Detailing (Rx-PAD) study database, pregnancy data from the Norwegian birth registry, and pharmacy dispension data from the Norwegian Prescription Database (NorPD).

METHOD: Records of patient contacts with 458 GPs, between December 2004 and February 2007, were screened for RTI episodes. Similar diagnoses were grouped together, as were similar antibiotics. Episodes were categorised according to whether the patient was pregnant or not, and included women aged 16-46 years. Logistic regression models were used to assess odds ratios (ORs), and calculated relative risks (cRRs) were produced. The authors also adjusted for clustering at various levels.

RESULTS: Overall prescription rate for RTI episodes was 30.8% (

CONCLUSION: Norwegian GPs prescribe fewer antibiotics overall when patients are pregnant and, when they do prescribe, choose more narrow spectrum antibiotics for RTIs. This indicates a possible lower target rate for GP prescriptions to females. A low antibiotic dispension rate during pregnancy may represent a discussion topic in the consultation setting, to address possible reasons and avoid under-treatment.

Keywords: anti-bacterial agents; general practice; physicians’ practice patterns; pregnancy; respiratory tract infections

Conflict of interest statement

SG: has ownership in the company that produces the data extraction software used in the Rx-PAD study and works there part time The other authors declare that no competing interests exist.

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