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

Figures & data

Figure 1.  Trends from July 1999 to December 2005 of number of physician visits calculated for the most common respiratory tract infections from July 1999 to December 2005. Note: The sum of all diagnoses is shown on the right-hand scale, individual diagnoses on the left.

Figure 2.  Trends from July 1999 to December 2005 of number of physician visits calculated for the most commonly used antibiotics from July 1999 to December 2005. Note: No antibiotics represents consultations where no antibiotic was prescribed.

Table I.  Number of physician consultations for the most common diagnoses during the studied six complete infectious seasons between January 2000 and December 2005.

	2000	2001	2002	2003	2004	2005	Total	%▵/yr	r	p-value
Common cold	11 813	14 816	13 448	11 695	10 418	11 525	73 715	−3.7%	−0.26	0.192
Tonsillitis	6144	6018	4698	4751	4255	3044	28 910	−11.7%	−0.81	0.000
AOM	4962	5673	5480	4076	3422	3464	27 077	−10.0%	−0.65	0.000
Acute bronchitis	3605	4073	3788	3350	3289	4055	22 160	−0.6%	−0.05	0.801
Sinusitis	3069	3299	3195	2774	2788	3048	18 173	−2.5%	−0.17	0.405
Pneumonia	2486	2461	2198	2007	1944	2629	13 725	−1.1%	−0.09	0.653
Pharyngitis	2181	2335	2080	2034	2033	1831	12 494	−3.5%	−0.51	0.007
Influenza	543	493	363	152	159	402	2112	−14.5%	−0.20	0.337
Laryngitis	189	201	195	198	146	171	1100	−6.4%	−0.51	0.008
Others	3683	3853	3723	3333	3515	3981	22 088	–
Total	38675	43222	39168	34370	31969	34150	221554

Notes: Correlations shown in bold are significant at p = 0.05. %Δ/yr = relative yearly change (%) during the observation period 1999–2005. r is the correlation coefficient.

Table II.  Relative antibiotic prescription pattern calculated for each age group, including consultations where an antibiotic was not prescribed (no antibiotics).

	Age 0–6	Age 7–17	Age 18–44	Age 45–64	Age 65–74	Age >74	Total (%)	Total (abs)
No antibiotics	59%	54%	52%	54%	55%	59%	55%	132457
Phenoxymethylpenicillin (J01CE)	29%	35%	30%	20%	16%	14%	27%	64864
Doxycycline (J01AA)	0%	1%	8%	17%	21%	19%	8%	19556
Erythromycin (J01F)	3%	4%	4%	3%	2%	1%	3%	7763
Amoxicillin (J01CA)	4%	2%	2%	3%	3%	3%	3%	6475
Cephalosporin (J01D)	1%	2%	2%	1%	1%	2%	2%	3633
Amoxicillin and clavulanic acid (J01CR)	2%	1%	0%	0%	0%	0%	1%	2053
Others	1%	2%	1%	1%	2%	2%	2%	3646
Total	100%	100%	100%	100%	100%	100%	100%
Visits total (abs)	54804	42575	69163	43496	14504	15905	240447
Antibiotics total (abs)	22655	19538	33002	19791	6528	6476	107990

Note: (abs) = absolute values.

Table III.  Changes over time in number of prescriptions of antibiotics in the various age groups.

	Age 0–6			Age 7–17			Age 18–44			Age 45–64			Age 65–74			Age >74
Treatment	%Δ/yr	r	p	%Δ/yr	r	p	%Δ/yr	r	p	%Δ/yr	r	p	%Δ/yr	r	p	%Δ/yr	r	p
No antibiotics	−4.5	−0.27	0.181	−7.8	−0.51	0.008	−3.6	−0.40	0.043	1.4	0.12	0.547	2.4	0.19	0.364	2.9	0.22	0.271
Phenoxymethylpenicillin	−9.4	−0.53	0.005	− − 12.6	−0.75	0.000	−8.8	−0.77	0.000	−4.7	−0.46	0.019	−4.1	−0.30	0.134	−1.9	−0.15	0.477
Doxycycline	−	−	−	6.8	0.21	0.305	2.1	0.13	0.538	4.5	0.27	0.181	4.1	0.28	0.162	4.7	0.32	0.112
Erythromycin	−12.5	−0.47	0.016	−12.0	−0.48	0.013	−11.6	−0.72	0.000	−6.2	−0.44	0.025	−0.4	−0.02	0.929	−7.4	−0.33	0.100
Amoxicillin	−10.7	−0.47	0.015	−14.5	−0.70	0.000	−8.0	−0.51	0.007	1.4	0.16	0.429	1.5	0.08	0.686	−0.4	−0.02	0.925
Cephalosporin	−22.5	−0.79	0.000	−11.7	−0.66	0.000	−15.2	−0.80	0.000	−6.6	−0.48	0.013	5.6	0.18	0.369	−0.4	−0.02	0.922
Amox + Clavul.acid	−19.2	−0.64	0.000	−13.4	−0.53	0.006	−10.9	−0.41	0.039	5.3	0.13	0.526	2.2	0.07	0.757	5.6	0.21	0.398

Note: “No antibiotics” represents consultations where an antibiotic was not prescribed. Correlations shown in bold are significant at p = 0.05.%Δ/yr = Relative yearly change (%) during the observation period 1999–2005. r is the correlation coefficient. All the statistically significant trends are de facto decreasing (negative%Δ/yr values (slopes)). Doxycycline is not used in age group 0–6.