The effect of reimbursement on the use of antibiotics.

Objective: To examine the effect of a reduction on the reimbursement of drugs on the use of antibiotics by general practitioners in Denmark.

Design: A prospective study using a questionnaire comparing the results with a similar study 3 years before, a period with normal reimbursement.

Participants: 553 general practitioners prescribed antibiotics for 5765 patients.

Main Outcome Measure: Number of treated patients and choice of antibiotics.

Results: 7607 patients were treated in 1987 compared with 5765 in 1990, the relative number of patients treated for sinusitis, other upper respiratory tract infections, acute bronchitis, pneumonia and upper gynaecological infections was significantly less in 1990 than in 1987. Other infections, particularly those that are often diagnosed by culture or microscopy by the general practitioners themselves, increased significantly. They included tonsillitis and urinary tract infections.

Conclusion: Reimbursement can be a very powerful tool controlling the use of antibiotics by general practitioners.