Journal Article

Antibiotic prescribing in primary care by international medical graduates and graduates from Swedish medical schools

Thomas Neumark, Lars Brudin and Sigvard Mölstad

in Family Practice

Volume 32, issue 3, pages 343-347
Published in print June 2015 | ISSN: 0263-2136
Published online February 2015 | e-ISSN: 1460-2229 | DOI:
Antibiotic prescribing in primary care by international medical graduates and graduates from Swedish medical schools

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Studies of antibiotic prescribing related to diagnosis comparing prescribers trained abroad with those trained in Sweden are lacking.


To determine whether general practices (GPs) and GP residents trained abroad had different prescribing patterns for antibiotics for common infections than those trained in Sweden using retrospective data from electronic patient records from primary health care in Kalmar County, Sweden.


Consultations with an infection diagnosis, both with and without the prescription of antibiotics to 67 GPs and residents trained in Western Europe outside Sweden and other countries, were compared with a matched control group trained in Sweden.


For 1 year, 44101 consultations of patients with an infection diagnosis and 16276 prescriptions of antibiotics were registered. Foreign-trained physicians had 20% more visits compared with physicians trained in Sweden. The prescription of antibiotics per visit and physician in the respective groups, and independent of diagnosis, did not significantly differ between groups, when scaled down from number of consultations to number of prescribing physicians.


There were minor and non-significant differences in antibiotic prescribing comparing GPs and residents trained abroad and in Sweden, most likely the result of an adaptation to Swedish conditions. Nevertheless, no group prescribed antibiotics in accordance to national guidelines. The results suggest that interventions are needed to reduce irrational antibiotic prescribing patterns, targeting all physicians working in Swedish primary health care

Keywords: Antibiotic prescribing; antibiotics; family practice; medical education; primary health care; trained abroad.

Journal Article.  3545 words. 

Subjects: Primary Care

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