Evidence map›Paper›PMID 40510011›Full record

ArticleFamily practice2025

Adherence to antibiotic prescribing guidelines in Dutch primary care: an analysis of national prescription data on ear and respiratory tract symptoms and conditions among 384 general practices.

Maarten Lambert, Renee Veldkamp, Yvette Weesie, Anke Lambooij, Jochen W L Cals, Katja Taxis, Liset van Dijk, Karin Hek

Abstract read
In one paragraph

Article in Family practice, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 2 papers.

0numbers the graph read from it
0cells of the map it votes in
2citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

2 citing papers in PubMed.

  1. Article
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4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

8 authors.

Maarten LambertUnit of PharmacoTherapy, Epidemiology and Economics, Groningen Research Institute of Pharmacy, University of Groningen, Antonius Deusinglaan 1, Groningen 9713 AV, The Netherlands.ORCID 0000-0003-4958-9920
Renee VeldkampNivel, Netherlands Institute for Health Services Research, Otterstraat 118, Utrecht 3515 CR, The Netherlands.
Yvette WeesieNivel, Netherlands Institute for Health Services Research, Otterstraat 118, Utrecht 3515 CR, The Netherlands.
Anke LambooijIVM, The Dutch Institute for Rational Use of Medicine, Churchilllaan 11, Utrecht 3527 GV, The Netherlands.
Jochen W L CalsDepartment of Family Medicine, Maastricht University Care and Public Health Research Institute, Maastricht University, Universiteitssingel 40, Maastricht 6229 ER, The Netherlands.ORCID 0000-0001-9550-5674
Katja TaxisUnit of PharmacoTherapy, Epidemiology and Economics, Groningen Research Institute of Pharmacy, University of Groningen, Antonius Deusinglaan 1, Groningen 9713 AV, The Netherlands.
Liset van DijkUnit of PharmacoTherapy, Epidemiology and Economics, Groningen Research Institute of Pharmacy, University of Groningen, Antonius Deusinglaan 1, Groningen 9713 AV, The Netherlands.
Karin HekNivel, Netherlands Institute for Health Services Research, Otterstraat 118, Utrecht 3515 CR, The Netherlands.ORCID 0000-0001-9551-1564

Funding

Netherlands Organisation for Health Research and Development 541003003ZonMw
6 · The paper itself

Abstract

backgroundMapping general practitioners' antibiotic prescribing practices is essential to optimize antibiotic use in primary care and mitigate antibiotic resistance.

objectivesThe objective of this study was to examine the adherence of Dutch general practitioners to prescribing guidelines for ear and respiratory tract symptoms and conditions.

methodsA cross-sectional study was conducted on Dutch electronic health records from 2018 to 2021. Antibiotic prescribing frequency and type were examined for ear and respiratory tract symptoms and conditions based on professional prescribing guidelines. Descriptive statistics and multilevel logistic regression analyses were applied.

resultsPatient records from up to 384 general practices were analysed for 15 ear and 27 respiratory tract conditions. For 11 of the 15 (73%) ear and 17 of the 27 (63%) respiratory tract conditions, more than 95% of patients were treated according to the prescribing guidelines. Most potential non-adherence to antibiotic prescribing guidelines occurred for acute otitis media (31%-34%), acute bronchitis/bronchiolitis (26%-39%), and acute sinusitis (25%-34%). Several other respiratory tract conditions showed non-indicated prescribing rates above 10%. For otitis externa, many broad-spectrum antibiotics were prescribed, which rarely happened for respiratory conditions. High variation in prescribing frequency and type between general practices occurred.

conclusionsFor most conditions, Dutch general practitioners adhere well to antibiotic prescribing guidelines. There are conditions for which there is a high potential for inappropriate prescribing. High variation between practices suggests room for improvement. Stricter implementation of prescribing guidelines may help improve prescribing practice. Alternatively, a practice-specific approach could be effective. The Dutch setting may be exemplary for international antibiotic prescribing practice.

Indexed as

Anti-Bacterial AgentsGeneral PracticeGuideline AdherencePractice Patterns, Physicians'Primary Health CareAdultAgedChildCross-Sectional StudiesDrug PrescriptionsFemaleHumansMaleMiddle AgedNetherlandsOtitis MediaAnti-Bacterial Agentsantibiotic prescribingear infectionselectronic health record datarespiratory tract infections

Identifiers

PMID40510011
PMCPMC12163312

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.