Skip to main content
main-content

01.12.2016 | Research article | Ausgabe 1/2016 Open Access

BMC Family Practice 1/2016

Combined assessment of clinical and patient factors on doctors’ decisions to prescribe antibiotics

Zeitschrift:
BMC Family Practice > Ausgabe 1/2016
Autoren:
Julia Strumiło, Sławomir Chlabicz, Barbara Pytel-Krolczuk, Ludmiła Marcinowicz, Dorota Rogowska-Szadkowska, Anna Justyna Milewska

Abstract

Background

Antibiotic overprescription is a worldwide problem. Decisions regarding antibiotic prescription for respiratory tract infections (RTIs) are influenced by medical and non-medical factors.

Methods

In family medicine practices in Białystok, Poland, family medicine residents directly observed consultations with patients with RTI symptoms. The observing residents completed a questionnaire including patient data, clinical symptoms, diagnosis, any prescribed antibiotic, and assessment of ten patient pressure factors.

Results

Of 1546 consultations of patients with RTIs, 54.26 % resulted in antibiotic prescription. Antibiotic prescription was strongly associated with rales (OR 26.90, 95 % CI 9.00–80.40), tonsillar exudates (OR 13.03, 95 % CI 7.10–23.80), and wheezing (OR 14.72, 95 % CI 7.70–28.10). The likelihood of antibiotic prescription was increased by a >7-day disease duration (OR 3.94, 95 % CI 2.80–5.50), purulent nasal discharge (OR 3.87, 95 % CI 2.40–6.10), starting self-medication with antibiotics (OR 4.11, 95 % CI 2.30–7.30), and direct request for antibiotics (OR 1.87, 95 % CI 1.30–2.80). Direct request not to prescribe antibiotics decreased the likelihood of receiving antibiotics (OR 0.34, 95 % CI 0.27–0.55).

Conclusion

While clinical signs and symptoms principally impact prescribing decisions, patient factors also contribute. The most influential patient pressure factors were starting self-medication with antibiotics, and directly requesting antibiotic prescription or no antibiotic prescription. Interventions aiming to improve clinical sign and symptom interpretation and to help doctors resist direct patient pressure could be beneficial for reducing unnecessary antibiotic prescribing.
Literatur
Über diesen Artikel

Weitere Artikel der Ausgabe 1/2016

BMC Family Practice 1/2016 Zur Ausgabe

Neu im Fachgebiet Allgemeinmedizin

Mail Icon II Newsletter

Bestellen Sie unseren kostenlosen Newsletter Update Allgemeinmedizin und bleiben Sie gut informiert – ganz bequem per eMail.

Bildnachweise