Antibiotic prescribing behavior among general practitioners – a questionnaire-based study in Germany

Abstract BackgroundUrinary tract infections (UTIs) are among the most common infections that require antibiotic therapy. In December 2015, new guidelines for UTI management were published in France with the aim of reducing antibiotic misuse and the risk of antimicrobial resistance.Objectives To analyze changes in antibiotic prescribing behavior for acute uncomplicated UTI in women in France from 2014 to 2019.MethodsRetrospective study using data extracted from the medico-administrative database 'OpenMedic' that is linked to the French National Health Data System and collects data on the reimbursement of prescribed drugs. The analyses focused on the number of boxes of antibiotics delivered by community pharmacies, the molecule class, and the prescriber's specialty.ResultsOverall, antibiotic dispensing by community pharmacies increased by 8% between 2014 and 2019, but with differences in function of the antibiotic class. The use of antibiotics recommended as first-line and second-line treatment increased (+ 41% for fosfomycin, + 7.53% for pivmecillinam). Conversely, the dispensing of lomefloxacin and norfloxacin decreased by 80%, and that of ciprofloxacin by 23%. Some antibiotics were mostly prescribed by general practitioners (lomefloxacin, pivmecillinam) and others by secondary care physicians (ofloxacin). The dispensing increase was higher for antibiotics prescribed by secondary care physicians than general practitioners (+21% and +5% between 2014 and 2019). ConclusionThese data suggest that the new recommendations are followed, as indicated by the increased prescription of fosfomycin and pivmecillinam and decreased prescription of fluoroquinolones. However, the efficient transmission and implementation of new recommendations by practitioners requires time, means and dedicated tools.

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Paper-based and web-based intervention modeling experiments identified the same predictors of general practitioners' antibiotic-prescribing behavior

Journal of Clinical Epidemiology ◽

10.1016/j.jclinepi.2013.09.015 ◽

2014 ◽

Vol 67 (3) ◽

pp. 296-304 ◽

Cited By ~ 5

Author(s):

Shaun Treweek ◽

Debbie Bonetti ◽

Graeme MacLennan ◽

Karen Barnett ◽

Martin P. Eccles ◽

...

Keyword(s):

General Practitioners ◽

Antibiotic Prescribing ◽

Web Based ◽

Prescribing Behavior

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Patterns of dental antibiotic prescribing in 2017: Australia, England, United States, and British Columbia (Canada)

Infection Control and Hospital Epidemiology ◽

10.1017/ice.2021.87 ◽

2021 ◽

pp. 1-8

Author(s):

Wendy Thompson ◽

Leanne Teoh ◽

Colin C. Hubbard ◽

Fawziah Marra ◽

David M. Patrick ◽

...

Keyword(s):

United States ◽

British Columbia ◽

Broad Spectrum ◽

Antibiotic Prescription ◽

Population Level ◽

The United States ◽

Antibiotic Prescribing ◽

Prescribing Behavior ◽

The Us ◽

Amoxicillin Clavulanic Acid

Abstract Objective: Our objective was to compare patterns of dental antibiotic prescribing in Australia, England, and North America (United States and British Columbia, Canada). Design: Population-level analysis of antibiotic prescription. Setting: Outpatient prescribing by dentists in 2017. Participants: Patients receiving an antibiotic dispensed by an outpatient pharmacy. Methods: Prescription-based rates adjusted by population were compared overall and by antibiotic class. Contingency tables assessed differences in the proportion of antibiotic class by country. Results: In 2017, dentists in the United States had the highest antibiotic prescribing rate per 1,000 population and Australia had the lowest rate. The penicillin class, particularly amoxicillin, was the most frequently prescribed for all countries. The second most common agents prescribed were clindamycin in the United States and British Columbia (Canada) and metronidazole in Australia and England. Broad-spectrum agents, amoxicillin-clavulanic acid, and azithromycin were the highest in Australia and the United States, respectively. Conclusion: Extreme differences exist in antibiotics prescribed by dentists in Australia, England, the United States, and British Columbia. The United States had twice the antibiotic prescription rate of Australia and the most frequently prescribed antibiotic in the US was clindamycin. Significant opportunities exist for the global dental community to update their prescribing behavior relating to second-line agents for penicillin allergic patients and to contribute to international efforts addressing antibiotic resistance. Patient safety improvements will result from optimizing dental antibiotic prescribing, especially for antibiotics associated with resistance (broad-spectrum agents) or C. difficile (clindamycin). Dental antibiotic stewardship programs are urgently needed worldwide.

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Changes in the management of urinary tract infections in women: impact of the new recommendations on antibiotic prescribing behavior in France, between 2014 and 2019

BMC Health Services Research ◽

10.1186/s12913-021-06653-4 ◽

2021 ◽

Vol 21 (1) ◽

Author(s):

Arthur Piraux ◽

Sébastien Faure ◽

Kurt G. Naber ◽

Jakhongir F. Alidjanov ◽

Aline Ramond-Roquin

Keyword(s):

Urinary Tract ◽

Urinary Tract Infections ◽

Secondary Care ◽

Administrative Database ◽

Community Pharmacies ◽

Antibiotic Prescribing ◽

Prescribing Behavior ◽

Using Data ◽

New Guidelines ◽

Tract Infections

Abstract Background Urinary tract infections (UTIs) are among the most common infections that require antibiotic therapy. In December 2015, new guidelines for UTI management were published in France with the aim of reducing antibiotic misuse and the risk of antimicrobial resistance. Objectives To analyze changes in antibiotic prescribing behavior for acute uncomplicated UTI in women in France from 2014 to 2019. Methods Retrospective study using data extracted from the medico-administrative database ‘OpenMedic’ that is linked to the French National Health Data System and collects data on the reimbursement of prescribed drugs. The analyses focused on the number of boxes of antibiotics delivered by community pharmacies, the molecule class, and the prescriber’s specialty. Results Overall, antibiotic dispensing by community pharmacies increased by 2% between 2014 and 2019, but with differences in function of the antibiotic class. The use of antibiotics recommended as first-line and second-line treatment increased (+ 41% for fosfomycin and + 7430% for pivmecillinam). Conversely, the dispensing of lomefloxacin and norfloxacin decreased by 80%, and that of ciprofloxacin by 26%. Some antibiotics were mostly prescribed by general practitioners (lomefloxacin, pivmecillinam) and others by secondary care physicians (ofloxacin). Dispensing increased for antibiotics prescribed by secondary care physicians (+ 13% between 2014 and 2019) and decreased for antibiotics prescribed by GPs (− 2% for the same period). Conclusion These data suggest that the new recommendations are followed, as indicated by the increased prescription of fosfomycin and pivmecillinam and decreased prescription of fluoroquinolones. However, the efficient transmission and implementation of new recommendations by practitioners requires time, means and dedicated tools.

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Use of point-of-care tests and antibiotic prescribing in sore throat and lower respiratory infections by general practitioners

Enfermedades Infecciosas y Microbiología Clínica ◽

10.1016/j.eimc.2019.02.005 ◽

2020 ◽

Vol 38 (1) ◽

pp. 21-24 ◽

Cited By ~ 2

Author(s):

Carles Llor ◽

José M. Molero ◽

Ana Moragas ◽

Gloria Cordoba ◽

Lars Bjerrum

Keyword(s):

Sore Throat ◽

General Practitioners ◽

Respiratory Infections ◽

Point Of Care ◽

Antibiotic Prescribing ◽

Point Of Care Tests

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General Practitioners’ Attitudes toward Municipal Initiatives to Improve Antibiotic Prescribing—A Mixed-Methods Study

Antibiotics ◽

10.3390/antibiotics8030120 ◽

2019 ◽

Vol 8 (3) ◽

pp. 120 ◽

Cited By ~ 3

Author(s):

Marthe Sunde ◽

Marthe Marie Nygaard ◽

Sigurd Høye

Keyword(s):

General Practice ◽

Quality Improvement ◽

Mixed Methods ◽

General Practitioners ◽

Treatment Guidelines ◽

National Level ◽

Medical Officer ◽

Mixed Methods Study ◽

Antibiotic Prescribing ◽

E Mail

Antimicrobial stewardship (AMS) interventions directed at general practitioners (GPs) contribute to an improved antibiotic prescribing. However, it is challenging to implement and maintain such interventions at a national level. Involving the municipalities’ Chief Medical Officer (MCMO) in quality improvement activities may simplify the implementation and maintenance, but may also be perceived challenging for the GPs. In the ENORM (Educational intervention in NORwegian Municipalities for antibiotic treatment in line with guidelines) study, MCMOs acted as facilitators of an AMS intervention for GPs. We explored GPs’ views on their own antibiotic prescribing, and their views on MCMO involvement in improving antibiotic prescribing in general practice. This is a mixed-methods study combining quantitative and qualitative data from two data sources: e-mail interviews with 15 GPs prior to the ENORM intervention, and online-form answers to closed and open-ended questions from 132 GPs participating in the ENORM intervention. The interviews and open-ended responses were analyzed using systematic text condensation. Many GPs admitted to occasionally prescribing antibiotics without medical indication, mainly due to pressure from patients. Too liberal treatment guidelines were also seen as a reason for overtreatment. The MCMO was considered a suitable and acceptable facilitator of quality improvement activities in general practice, and their involvement was regarded as unproblematic (scale 0 (very problematic) to 10 (not problematic at all): mean 8.2, median 10). GPs acknowledge the need and possibility to improve their own antibiotic prescribing, and in doing so, they welcome engagement from the municipality. MCMOs should be involved in quality improvement and AMS in general practice.

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Understanding physician antibiotic prescribing behavior for children with enterovirus infection

PLoS ONE ◽

10.1371/journal.pone.0202316 ◽

2018 ◽

Vol 13 (9) ◽

pp. e0202316

Author(s):

Kuang-Che Kuo ◽

Yi-Chun Yeh ◽

Ying-Hsien Huang ◽

I-Ling Chen ◽

Chen-Hsiang Lee

Keyword(s):

Antibiotic Prescribing ◽

Enterovirus Infection ◽

Prescribing Behavior

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Parental self-medication with antibiotics for children promotes antibiotic over-prescribing in clinical settings in China

Antimicrobial Resistance and Infection Control ◽

10.1186/s13756-020-00811-9 ◽

2020 ◽

Vol 9 (1) ◽

Author(s):

Jiayao Xu ◽

Xiaomin Wang ◽

Kai Sing Sun ◽

Leesa Lin ◽

Xudong Zhou

Keyword(s):

Antibiotic Use ◽

Antibiotic Prescribing ◽

Clinical Settings ◽

Cross Sectional Survey ◽

Self Medication ◽

Cross Sectional ◽

Prescribing Behavior ◽

The Past ◽

Outpatient Settings ◽

The Impact

Abstract Background Self-medication with antibiotics (SMA) is one of the most dangerous inappropriate antibiotic use behaviors. This study aims to investigate the impact of parental SMA for children before a consultation on their doctor’s subsequent antibiotic prescribing behavior, including intravenous (IV) antibiotic use in the clinical setting of China. Methods A cross-sectional survey was conducted between June 2017 and April 2018 in three provinces of China. A total of 9526 parents with children aged 0–13 years were investigated. Data from 1275 parents who had self-medicated their children and then visited a doctor in the past month were extracted and analyzed. Results One-third (410) of the studied children had parental SMA before the consultation and 83.9% of them were subsequently prescribed antibiotics by doctors. Children with parental SMA were more likely to be prescribed antibiotics (aOR = 7.79, 95% CI [5.74–10.58]), including IV antibiotics (aOR = 3.05, 95% CI [2.27–4.11]), and both oral and IV antibiotics (aOR = 3.42, 95% CI [2.42–4.84]), than children without parental SMA. Parents with SMA behaviors were more likely to request antibiotics (aOR = 4.05, 95% CI [2.59–6.31]) including IV antibiotics (aOR = 2.58, 95% CI [1.40–4.76]), and be fulfilled by doctors (aOR = 3.22, 95% CI [1.20–8.63]). Conclusions Tailored health education for parents is required in both community and clinical settings to discourage parental SMA for children. The doctors should not prescribe unnecessary antibiotics to reinforce parents’ SMA behaviors. We recommend expanding the current IV antibiotics ban in outpatient settings of China to cover outpatient pediatrics.

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