| Antibiotic misuse and overuse increase health care costs while promoting antibiotic resistance. The identification of physician characteristics predictive of poor antibiotic prescribing could enable targeted educational interventions before physicians' entry into practice.; The objective of this study was to assess whether physicians' medical school training, licensure examination scores, and time in practice could predict antibiotic prescribing behaviour.; A historical cohort consisting of 912 physicians who obtained certification in 1990--1993 and subsequently entered fee-for-service practice in Quebec, and the 4,258,362 patients they saw during 1990--1998 was used. Multivariate logistic regression analyses for clustered data were performed.; Foreign medical graduates were more likely to prescribe antibiotics for viral respiratory infections (RRadjusted 1.78, 95%CI 1.30, 2.44). Physicians who scored higher on the Medical Council of Canada Qualifying Examination were more likely to prescribe newly marketed antibiotics (RRadjusted 1.19, 95%CI 1.07, 1.33). The likelihood of unnecessary and inappropriate antibiotic prescribing increased with practice experience. |
