The rates of compliance with the guidelines were similar between physician assistants and general practitioners, 86.2% and 85.3%, respectively. All the prescriptions written by specialists complied with the guidelines. It should be noted, however, that there were only five such prescriptions (Table 4). buy levaquin online
TABLE 4 Rate of compliance with guidelines
|Prescriber type||TotalnumberofRxs||Number of Rxs complying with guidelines||Rate of compliance (%)|
GP General practitioner; PA Physician assistant; Rx Prescription; SP Specialist
After eliminating indications for which only a small number of prescriptions were written, six indications were associated with a noncompliance rate of more than 5%: bronchitis, cellulitis, CAP, OM, pharyngitis and sinusitis (Table 5). Based on the definition of noncompliance, the antibiotics prescribed for these cases were not among the agents recommended in either of the two guidelines.
TABLE 5 Main indications associated with noncompliance
CAP Community-acquired pneumonia; MO Medical officers (general practitioners and medial specialists); OM Otitis media; PA Physician assistants
A number of prescriptions only partially complied with the guidelines because, despite using the appropriate antibiotic, other aspects of these prescriptions failed to meet the recommendations. Partial compliance involved the dose, the duration of treatment, or for a limited number of cases, the omission to prescribe a second anti-infective when a combination of antibiotics was recommended. Refering to Table 6, 21.8% and 14.5% of prescriptions partially met the recommendations from the Ontario Review Panel and the Sanford’s Guide, respectively. A higher proportion of prescriptions signed by physician assistants were involved in partial compliance cases compared with prescriptions from general practitioners. It is difficult to draw any conclusions concerning prescriptions written by specialists, due to the small sample size.
TABLE 6 Rate of partial compliance with guidelines
|Prescriber type||Ontario n (%)*||Sanford n (%)*|
|PA||70 (27.6)||41 (16.1)|
|GP||34 (15.6)||27 (12.4)|
|Total||104 (21.8)t||69 (14.5)t|
GP General practitioner; PA Physician assistant; SP Specialists. *Represents the percentage of prescriptions partially complying with the treatment recommendations based on the total number of prescriptions written per type of prescriber. fRepresents the percentage of prescriptions partially complying with the treatment recommendations based on the total number of prescriptions