A survey of patient behaviours and beliefs regarding antibiotic self-medication for respiratory tract infections in Poland.

INTRODUCTION: Self-medication can contribute to the inappropriate use of antibiotics in respiratory tract infections (RTI). This phenomenon has not been well described, particularly in Poland. The aim of our study was to describe the prevalence of antibiotic self-medication for RTI, to explore factors influencing antibiotic use without prescription, and to determine the available sources of such antibiotics. MATERIAL AND METHODS: A self-administered questionnaire completed by patients presenting to family medicine clinics at Lodz and Wroclaw from 1(st) March to 15(th) May 2010. RESULTS: A total of 891 patients in ten clinics completed the survey (response rate, 89.1%). Overall, 41.4% (n = 369) of patients reported self-medication with an antibiotic for RTI. The most common reason for antibiotic self-medication was a belief that antibiotics treat the majority of infections, including influenza and influenza-like illnesses (43.9%; n = 162). The predominant sources of antibiotics for self-medication were antibiotics from previous prescriptions stored by the patient at home (73.7%, n = 272), those received from a pharmacy without prescription (13.5%; n = 50), or from family members and friends (12.7%; n = 47). CONCLUSIONS: Antibiotic self-medication for RTI was common in this population. This may be due to the belief that the antibiotics treat the majority of infections. A recommendation to either ask patients to return unused antibiotics to the physician's office or to dispense antibiotics in the exact amount which is necessary for an individual course, as well as the targeted education of pharmacy personnel and the general population, appear to be justified.

Presentation, antibiotic management and associated outcome in Polish adults presenting with acute cough/LRTI.

OBJECTIVE: In-depth knowledge of existing practice is required to inform interventions aimed at antibiotic prescribing quality improvement. We set out to describe the presentation, antimicrobial management and associated outcome of adults presenting in general practice with acute cough/lower respiratory tract infection (LRTI) in Poland. METHODS: Observational study of 301 adults with acute cough/LRTI. Clinicians completed a case report form (CRF) describing presentation, history and management and patients completed a symptom diary for up to 28 days after consultation. RESULTS: Two hundred and twenty-one patients (with CRF and symptom diary completed) were analysed. The median duration of feeling unwell before presentation was 4 days. Clinicians recorded an average of eight symptoms for patients at presentation. Apart from cough, patients most commonly reported feeling generally unwell (91.9%), limitation of normal activities (80.5%), coryza (80.1%) and phlegm production (76.0%). Auscultation abnormalities were present in 55.0%. Overall, medicines were prescribed for 95.0%; 72.4% were prescribed antibiotics [mostly macrolides/lincosamides (38.8%) and amoxicillin/co-amoxiclav (36.3%)) with 11.3% advised to take antibiotics only if still necessary after a specified delay. Mucolytics were prescribed for 61.1%. Antibiotic prescription was strongly associated with a diagnosis of LRTI and the presence of auscultation abnormalities. The median duration of cough after presentation was 8 days. CONCLUSIONS: Antibiotics continue to be frequently prescribed for acute cough/LRTI in Poland, and the decision to prescribe was strongly associated with clinicians' findings of abnormalities on auscultation and diagnosis of LRTI. Delayed prescribing was infrequent. Mucolytics were commonly prescribed despite evidence of no effect.

Decisions on sick leave certifications for acute airways infections based on vignettes: a cross-sectional survey of GPs in Norway and Poland.

OBJECTIVE. To explore whether frequency and duration of sick-leave certification for acute airway infections differ between general practitioners (GPs) in Poland and Norway. DESIGN. Cross-sectional survey. SETTING. Educational courses for GPs. Intervention. We used a questionnaire with four vignettes presenting patients with symptoms consistent with pneumonia, sinusitis, common cold, and exacerbation of chronic obstructive pulmonary disease (COPD), respectively. For each vignette GPs were asked whether they would offer a sick-leave note, and if so, for how many days. Subjects. Convenience samples of GPs in Poland (n = 216) and Norway (n = 171). MAIN OUTCOME MEASURES. Proportion of GPs offering a sick-leave certificate. Duration of sick-leave certification. Results. In Poland 100%, 95%, 87%, and 94% of GPs would offer sick leave for pneumonia, sinusitis, common cold, and exacerbation of COPD, respectively. Corresponding figures in Norway were 97%, 83%, 60%, and 90%. Regression analysis adjusting for the GPs' sex, speciality, experience, and workload indicated that relative risks for offering sick leave (Poland versus Norway) were 1.16 (95% CI 1.07-1.26) for sinusitis and 1.50 (1.28-1.75) for common cold. Among GPs who offered sick leave for pneumonia, sinusitis, common cold, and exacerbation of COPD, mean duration was 8.9, 7.5, 5.1, and 6.9 days (Poland) versus 6.6, 4.3, 3.1, and 6.1 days (Norway), respectively. In regression analyses the differences between the Polish and Norwegian samples in duration of sick leave were statistically significant for all vignettes. A pattern of offering sick leave for three, five, seven, 10, or 14 days was observed in both countries. CONCLUSION. In the Polish sample GPs were more likely to offer sick-leave notes for sinusitis and common cold. GPs in Poland offered sick leaves of longer duration for pneumonia, sinusitis, common colds, and exacerbation of COPD compared with GPs in the Norwegian sample.

Sickness certification for patients with acute cough/LRTI in primary care in Poland and Norway.

OBJECTIVE: To compare the frequency and duration of sickness certificates issued by GPs to Polish and Norwegian working adults with acute cough/lower respiratory tract infection (LRTI). DESIGN: Cross-sectional observational study with clinicians from nine primary care centres in Poland and 11 primary care centres in Norway. GPs filled out a case report form for all patients, including information on antibiotic prescribing, sickness certification, and advice to stay off work. SETTING: Primary care research networks in Poland and Norway. SUBJECTS: Working adults with a new or worsening cough or clinical presentation suggestive of LRTI. MAIN OUTCOME MEASURES: Issuing sickness certificates and advising patients to stay off work. RESULTS: GPs recorded similar symptoms and signs in patients in the two countries. Antibiotics were prescribed more often in Polish than in Norwegian patients (70.4% vs. 27.1%, p < 0.0001). About half of the patients received a formal sickness certificate (50.5% in Norway and 52.0% in Poland). The proportion of patients advised to stay off work was significantly higher in the Polish sample compared with the Norwegian sample (75.2% vs. 56.1%, p = 0.002). Norwegian GPs less often issued sick certificates for more than seven days (5.6% vs. 36.9%, p < 0.0001). CONCLUSION: The overall proportion of sickness certification for acute cough/LRTI was similar in Norwegian and Polish patients. However, in the Polish sample, GPs more often advised patients to take time off work without issuing a sick note. When sickness certificates were issued, duration of longer than seven days was more common in Polish than in Norwegian patients.

[A blinded comparison of palatability of 13 common pediatric antibiotic suspensions]. / Porównanie parametrów organoleptycznych 13 popularnych antybiotyków w postaci zawiesin dla dzieci--badanie z zastosowaniem slepej próby.

UNLABELLED: Non-compliance is one of the leading reasons of therapy failure in case of antibiotherapy of respiratory tract infections in children. The organoleptic characteristic of the antibiotic suspension has strong influence on compliance in children. The aim of the present study was to compare taste and the other organoleptic factors of commonly prescribed antibiotics in order to find which of them are palatable to the extent which may positively influence patient compliance. METHODS: 13 antibiotic suspensions were arbitrary chosen for the comparison. These drugs were blindly evaluated by 25 volunteers as to the appearance, smell, texture, taste and aftertaste compared to amoxycillin (Amotaks) as a reference dug. The overall score was calculated, as well. In the statistical analysis Duncan's test was used. RESULTS: The important diversity of scores of assessed antibiotics was observed in every category. In most cases clindamycin and macrolides obtained the lowest scores, penicillins and co-trimoxazol--medium ones and cephalosporins--the best scores. Among penicillins, amoxicillins with clavulanic acids were scored lower than pure amoxicillins. In overall score, different preparations of the same substance obtained similar scores, statistically non-different, with one exception for clarithromycin, in which Klacid was characterized by better palatability. CONCLUSION: Observed differences in organoleptic characteristics of studied drugs may significantly influence patient compliance and therefore should be taken into consideration in the case of antibiotic selection for the treatment of infection in children.