Primary Healthcare Physicians' Insufficient Knowledge Is Associated with Antibiotic Overprescribing for Acute Upper Respiratory Tract Infections in China: A Cross-Sectional Study.

IF 4.3 2区医学 Q1 INFECTIOUS DISEASES

Antibiotics-Basel Pub Date : 2024-09-26 DOI:10.3390/antibiotics13100923

Muhtar Kadirhaz, Yushan Zhang, Naveel Atif, Wenchen Liu, Wenjing Ji, Nan Zhao, Jin Peng, Sen Xu, Miaomiao Xu, Chengzhou Tang, Yu Fang, Jie Chang

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引用次数: 0

Abstract

Objectives: Overuse of antibiotics in healthcare remains prevalent and requires urgent attention in China, particularly in primary healthcare (PHC) facilities. This study aimed to describe the patterns of antibiotic prescriptions for acute upper respiratory tract infections (URTIs) in PHC facilities in China and to investigate how PHC physicians' knowledge influences their antibiotic prescribing behavior.

Methods: A cross-sectional survey linking physician questionnaire responses and their prescription data was conducted in Shaanxi Province, China. The proportions of URTI visits that received at least one antibiotic, combined antibiotics, and broad-spectrum antibiotics were the main outcomes reflecting antibiotic prescribing behavior. Multivariate mixed-effects logistic regressions were applied to analyze the relationship between PHC physicians' knowledge about antibiotics and their antibiotic prescribing behavior.

Results: A total of 108 physicians filled out the questionnaires between February 2021 and July 2021, and a sample of 11,217 URTI visits attended by these physicians from 1 January 2020 to 31 December 2020 were included in the analysis. The overall mean score of our respondents on the knowledge questions was 5.2 (total score of 10). Over sixty percent (61.2%; IQR 50.2-72.1) of the URTI visits received antibiotics. The percentages of URTI visits prescribed with combined and broad-spectrum antibiotics were 7.8% (IQR 2.3-10.2) and 48.3% (IQR 36.7-58.7), respectively. Third-generation cephalosporins were the most frequently used antibiotics. Physicians with lower antibiotic knowledge scores were more inclined to prescribe antibiotics (p < 0.001), combined antibiotics (p = 0.001), and broad-spectrum antibiotics (p < 0.001).

Conclusions: Physicians' insufficient knowledge was significantly associated with antibiotic overprescribing. Professional training targeting physicians' knowledge of antibiotics is urgently needed to improve the rational use of antibiotics in grassroots healthcare facilities in China.

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中国初级保健医生知识不足与急性上呼吸道感染抗生素处方过量有关：一项横断面研究。

目的：在中国，尤其是在基层医疗卫生机构中，过度使用抗生素的现象仍然普遍存在，亟需引起重视。本研究旨在描述中国初级卫生保健机构中急性上呼吸道感染（URTI）的抗生素处方模式，并探讨初级卫生保健机构医生的知识水平如何影响其抗生素处方行为：方法：在中国陕西省开展了一项横断面调查，将医生的问卷回答与处方数据联系起来。至少使用一种抗生素、联合使用抗生素和广谱抗生素的尿毒症就诊比例是反映抗生素处方行为的主要结果。采用多变量混合效应逻辑回归分析了初级保健医生的抗生素知识与抗生素处方行为之间的关系：共有 108 名医生在 2021 年 2 月至 2021 年 7 月期间填写了调查问卷，这些医生在 2020 年 1 月 1 日至 2020 年 12 月 31 日期间接诊的 11,217 例 URTI 患者被纳入分析样本。受访者在知识问题上的总平均分为 5.2 分（总分 10 分）。超过六成（61.2%；IQR 50.2-72.1）的 URTI 就诊者使用了抗生素。在就诊的 URTI 患者中，使用联合抗生素和广谱抗生素的比例分别为 7.8%（IQR 2.3-10.2）和 48.3%（IQR 36.7-58.7）。第三代头孢菌素是最常用的抗生素。抗生素知识得分较低的医生更倾向于处方抗生素（p < 0.001）、联合抗生素（p = 0.001）和广谱抗生素（p < 0.001）：结论：医生的抗生素知识不足与抗生素处方过量有很大关系。中国基层医疗机构急需开展针对医生抗生素知识的专业培训，以提高抗生素的合理使用。

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来源期刊

Antibiotics-Basel Pharmacology, Toxicology and Pharmaceutics-General Pharmacology, Toxicology and Pharmaceutics

CiteScore

7.30

自引率

14.60%

发文量

1547

审稿时长

11 weeks

期刊介绍： Antibiotics (ISSN 2079-6382) is an open access, peer reviewed journal on all aspects of antibiotics. Antibiotics is a multi-disciplinary journal encompassing the general fields of biochemistry, chemistry, genetics, microbiology and pharmacology. Our aim is to encourage scientists to publish their experimental and theoretical results in as much detail as possible. Therefore, there is no restriction on the length of papers.