Trends in number of consultations and antibiotic prescriptions for respiratory tract infections between 1999 and 2005 in primary healthcare in Kalmar County, Southern Sweden

Scand J Prim Health Care. 2009;27(1):18-24. doi: 10.1080/02813430802610784.


BACKGROUND. Respiratory tract infections (RTIs) comprise the most common indication for consulting a general practitioner and obtaining an antibiotic prescription.

Objective: To study changes in the number of visits, diagnoses, and antibiotic prescriptions for RTI in primary healthcare during the period 1999-2005.

Design: A retrospective, descriptive, population-based study of electronic patient records. Setting. County of Kalmar in southeastern Sweden.

Patients: Patients visiting primary healthcare units in Kalmar County for an RTI between 1 July 1999 and 31 December 2005.

Main outcome measures: RTI diagnoses, antibiotic prescriptions, age groups.

Results: A total of 240 447 visits for RTI made between 1999 and 2005 were analysed. The yearly consultation rates for the diagnoses acute tonsillitis and AOM decreased by 12% and 10%, respectively (p = 0.001). Of all patients consulting for an RTI diagnosis, 45% received antibiotics. Of all prescribed antibiotics, 60% were for phenoxymethylpenicillin (PcV) and 18% doxycycline. Amoxicillin or amoxicillin + clavulanic acid was prescribed to a lesser extent. The proportion of patients obtaining an antibiotic prescription was almost constant over time (44-46%). The prescriptions of doxycycline showed increasing values (NS). The prescriptions of remaining antibiotics decreased significantly especially for patients up to middle age.

Conclusion: This large population study, comprising more than six years of observations, showed the number of primary healthcare patients receiving an RTI diagnosis decreased during the period 1999-2005, but the proportion of patients receiving an antibiotic prescription remained the same. The large seasonal variations indicate a need for further interventions to decrease antibiotic use for RTIs.

MeSH terms

  • Adolescent
  • Adult
  • Aged
  • Anti-Bacterial Agents / administration & dosage*
  • Drug Prescriptions / statistics & numerical data
  • Drug Utilization Review / statistics & numerical data
  • Family Practice / statistics & numerical data*
  • Female
  • Humans
  • Male
  • Middle Aged
  • Office Visits / statistics & numerical data
  • Practice Patterns, Physicians' / statistics & numerical data
  • Practice Patterns, Physicians' / trends
  • Respiratory Tract Infections / diagnosis
  • Respiratory Tract Infections / drug therapy*
  • Respiratory Tract Infections / epidemiology
  • Retrospective Studies
  • Sweden / epidemiology
  • Young Adult


  • Anti-Bacterial Agents