1. Happy Audit II 2012 S. Chlabicz Department of Family Medicine and Community Nursing Medical University of Bialystok, Poland BARN meeting WARSAW 2013

2. Background Prescribing antibiotics for infections is an everyday activity in primary care Important for individual patient and for public health We can measure and implement quality of care in chronic conditions (Hypertension, Diabetes, Cardiac failure) Why not in anb prescribing?

5. Does more tests equal less anb? Poland versus Latvia PolandLatvia Duration days (mean) 4,84,9 Age years (mean)2728 Fever %33,238,9 % lab test (at least one) 11,432,2 % ANB38,241,5

7. Choice of laboratory tests? Is use of CRP in 50% of patients in Sweden justified? Is use of CXR in 17,6% patients in Kaliningrad justified (mean duration of symptoms 2,6 days)?

9. Conclusions 1.Huge variations between countries 2.Data on prescribing habits of individual doctors should be routinely available 3.Educational campaigns should probably encourage pts not to present early to a doctors with symptoms of RTI 4.More lab tests does not necessarily equal less anb 5.Varied use of additional tests (CRP, CXR) reflects lack of consensus on their utility

10. Limitations 1.Not a random sample 2.Doctors aware of being monitored 3.Reported behaviour

11. Thank you for your attention