Use of antibiotics by primary care doctors in Hong Kong

General practitioners in Hong Kong were invited to fill in a short questionnaire on every patient with infection that they had seen on the first full working day once every three months for four consecutive quarters starting from December 2005.Forty six primary care doctors took part and a total of 3096 completed questionnaires were returned. The top three diagnoses were upper respiratory tract infection (46.7%), gastrointestinal infection (8.2%) and pharyngitis (7.1%). Thirty percent of patient encounters with infections were prescribed antibiotics but only 5.2% of patient encounters with upper respiratory tract infection (URTI) were prescribed antibiotics. Amino-penicillins were the most commonly used antibiotics while beta-lactam/beta-lactamase inhibitor combinations (BLBLIs) were the second most commonly used antibiotics and they accounted for 16.5% and 14.0% of all antibiotics used respectively. Of all patients or their carers, those who demanded or wished for antibiotics were far more likely to be prescribed antibiotics (Pearson chi-square test, p < 0.0001). Those patients who were attending the doctors for follow-up consultations were also more likely to be prescribed antibiotics (Pearson chi-square test, p < 0.001).The antibiotic prescribing patterns of primary care doctors in Hong Kong are broadly similar to primary care doctors in other developed countries but a relatively low rate of antibiotics is used for URTI.Overuse of antibiotics is a worldwide phenomenon [1,2] and it contributes to the emergence of antimicrobial resistance [3-5]. Unnecessary use of antibiotics also leads to an increased risk of side effects [6], increased medical care costs [7] and medicalising effects [8].In the Fifty-eighth World Health Assembly held in May 2005, it was resolved and agreed by more than 60 countries that the containment of antimicrobial resistance is an international goal; however the strategy for doing this has not been widely implemented. This assembly urged memb