Objective: To report the variability in antibiotic prescribing habits for patients diagnosed of non-specified acute respiratory infections (ARI) (according to the International Classification of Diseases 9MC) at Emergency Departments of ten Spanish hospitals, and to evaluate the appropriateness of antimicrobial prescription for such patients, after specifically elaborating some reference patterns for appropriate antimicrobial use.
Design: Descriptive study of variability in clinical practice by means of a prospective series of cases. Study of appropriateness by means of elaborating reference standards for appropriate use and comparison with the data from the descriptive study with such standards.
Duration: six months.
Setting: Emergency Department in ten Spanish hospitals from different autonomic communities: Andalucía, Islas Canarias, Castilla-León, Cataluña, Galicia, Madrid, Murcia and Valencia for a 6-month period.
Patients: Patients with the diagnosis of community ARI attended at emergency departments.
Sample size: 903 cases.
Interventions: Collection of cases in a unified database with the following variables: age, sex, ARI type, diagnosis of comorbidity, prescribed antimicrobial, hospital admission and type of prescriber. A panel of experts was commissioned to elaborate the gold standards for the appropriate use of antibiotics or the lack of indication for the different locations of ARI.
Results: The adjusted proportion of the inappropriate prescription for the group with laryngo-tracheal-influenza-rhinopharyngitis-multiple ARI or non specified infections was 67.9%.
Conclusions: Concerning antibiotic prescription, significant inter-center variability and relevant heterogeneity were observed.