• Samuel Coenen, Ineke Welschen, Van Royen Paul P, Marijke M Kuyvenhoven, Joke Denekens, and Theo J M Verheij.
• Centre for General Practice, University of Antwerp, BE 2610 Antwerp, Belgium. samuel.coenen@ua.ac.be
• Eur J Gen Pract. 2004 Dec 1; 10 (4): 152-6.

ObjectivesIn Europe there are large variations in overall outpatient antibiotic use, even between two neighbouring countries as Belgium and the Netherlands. We aimed to compare the management of acute cough between Belgian and Dutch general practitioners (GPs).MethodsIn cross-sectional studies in Belgium and the Netherlands, 71 Belgian and 84 Dutch GPs included adult patients consulting for acute cough. Differences in antibiotic prescription rates, the percentage of first-choice antibiotics (i.e. tetracyclines and broad-spectrum penicillins) and bronchodilator prescription rates were assessed by using Generalised Estimates Equations to adjust for clustering of patients within GPs.ResultsIn Belgium 324/810 patients (40%) were prescribed an antibiotic compared with 101/309 (33%) in the Netherlands (adjusted OR (95% CI) 1.28 (0.91-1.83)). Belgian GPs prescribed fewer first-choice antibiotics compared with Dutch GPs: 124/324 (38%) versus 67/101 (66%) (adjusted OR (95% CI) 0.39 (0.22-0.72)). In both countries, 17% of the patients were prescribed a bronchodilator.ConclusionsAntibiotic prescription rates for adult patients with acute cough were not significantly higher in Belgian than in Dutch general practice at the 5% significance level. Dutch GPs' antibiotic prescriptions were more in line with national guidelines. Bronchodilator prescription rates were similar. Because Dutch GPs probably encountered more severe cases of acute cough compared with their Belgian colleagues, the observed prescribing differences might be underestimated.

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