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Patient demand for antibiotic prescription. An often-neglected cause of antibiotic resistance in the community

Abstract number: 1734_128

Alevizos A., Perimeni D., Larios G., Mihas C., Fanou D., Papathanasiou M., Trifynopoulou K., Stamatiou K., Kintzoglanakis K., Mariolis A.

Background: A small, yet important number of patients are inadequately prescribed antibiotic treatment for viral upper respiratory tract infections (VURTIs). General Practitoners (GPs) are one of the main sources of such antibiotic prescriptions. Insistent patient demand has been associated with such antibiotic prescriptions. In the present study we tried to estimate the impact of patients' demand on physicians' decisions in an urban primary healthcare centre in Athens, Greece, a country which currently presents one of the worst antibiotic resistance patterns in Europe.

Methods: The material of our study consisted of 21 GPs of the Health Centre of Vyronas, who were asked to document their rationale for prescribing antibiotics in patients with VURTI, as recorded to the official registry of the Health Centre in a 6-month period, from October 2005 to March 2006, with the typical seasonal peaks in viral respiratory tract infections. The physicians were asked to state the medical reasons as well as the patient demand-related reasons that influenced them the most in making their decisions.

Results: 58 prescriptions of antibiotics in patients with VURTI were found in our registries. 27 out of 58 (46.5%) of prescriptions were documented as necessary by the health status or by other various concomitant medical conditions of the patients (COPD exacerbations, asthma, diabetes, immunosuppression, etc.). According to the physicians' responses, from the remaining 31 prescriptions, 12 (38.7%) were made because of diagnostic uncertainty reasons, while the remaining 19 (61.3%) were actually prescribed because of persistent patient demand. Interestingly, most of the physicians stated that a far greater number of patients with VURTI examined during the same period were not prescribed antibiotic treatment despite their insistent demand.

Conclusion: Patient demand, although not being the most important factor, greatly influences physicians and has a significant effect on antibiotic prescribing for VURTIs. Adequate practice guidelines and intervention strategies from health policy makers aiming to ameliorate antibiotic prescribing patterns in primary healthcare have to take such effect into consideration in order to effectively decrease the expansion of antibiotic resistance in the community.

Session Details

Date: 31/03/2007
Time: 00:00-00:00
Session name: European Society of Clinical Microbiology and Infectious Diseases
Subject:
Location: ICC, Munich, Germany
Presentation type:
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