Sultamicillin in the Out-patient Care of General Practitioners and Specialists

Overview

The objective of analysis of patient population treated with sultamicillin on out-patient basisduring a period from September 10th 2001 - December 31st 2002 was not only evaluation oftreatment efficacy and safety, but also evaluation of general practitioners common habits whenindicating antibiotic therapy. In the study there participated 223 physicians who filled outquestionnaire on treatment of overall 7287 patients. Through a method of stratified randomselection, 1523 questionnaires were selected for evaluation. Men and women were equallyrepresented (men - 716, women 771, in 36 patients sex was not specified), 1059 (almost 70%)patients were at the age of 21-60 years, while children and adolescents up to the age of 20 yearsas well as the elderly over the age of 60 years were represented by 15% each. Indications forsultamicillin administration included acute bronchitis in 451 patients (29.6%), pharyngitis in431 patients (28.3%), followed by sinusitis (182 patients, 12.0%), urological infections (121patients, 7.9%) and other diagnoses in relatively small representation. As pharyngitis usuallyis of viral etiology, antibiotic administration can’t influence course of the disease and thereforewe do not consider it as indicated, 431 protocols with given diagnosis of pharyngitis (28.3% outof overall number) were excluded from further evaluation. Therefore, final population consistedof 1092 patients. Before initiation of antibiotic treatment FW was performed in 298 patients(27.3%), blood count in 10 cases (9.7%) and CRP in 85 patients (7.8%). Material for investigationby cultivation was transferred in 117 patients (10.7%). Out of respiratory tract infections,cultivation was the most frequently performed in tonsillitis (22.2%) and pneumonia (15.6%). In urinary tract infections, urine cultivation was performed in 37.2%. Overall, sultamicillinadministration resulted in cure of 839 patients (76.8%), improvement of conditions occurred in228 cases (20.9%). Failure or recurrence occurred in 22 patients (2.0%). Adverse drug reactionsdeveloped in overall 125 cases (11.4%), diarrhoea (103 cases) being the most frequent reaction.In such cases treatment required interruption in 11 patients (1% out of overallnumber of treatedpatients). Out of evaluation of this population it resulted that1. in antibiotic indication physicians usually follow clinical diagnosis, less often laboratorymarkers of inflammation or cultivation findings with antibiogram2. antibiotics are still often administrated to patients with pharyngitis which is mostly of viralorigin3. sultamicillin is a very effective antibiotic in treatment of respiratory and urinary tractinfections4. due to low incidence of adverse drug reactions it is rated among safe antibiotics.

Key words:
sultamicillin - out-patient care - infections - respiratory tract - urinary tract.