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- Title
A national cross-sectional study on socio-behavioural factors that influence physicians' decisions to begin antimicrobial therapy.
- Authors
Velasco, E.; Espelage, W.; Faber, M.; Noll, I.; Ziegelmann, A.; Krause, G.; Eckmanns, T.
- Abstract
Purpose: Current efforts to prevent antimicrobial resistance include limiting antimicrobial use, providing education about appropriate use, and developing better point-of-care tests, but what do physicians actually think of rational prescribing and potential interventions? We tried to ascertain which factors can influence a physician's decision to start antimicrobial therapy on a patient, and their opinions on measures to promote rational prescribing. Methods: We conducted a nationwide, cross-sectional survey of 10,600 physicians from medical registries of all known board-certified physicians in Germany. Results: Among respondents ( n = 3,492; 33%; detailed non-response bias analysis included), 90% indicated that they decide to start antimicrobial therapy on a patient at least weekly, and 66% reported that they decide daily. We identified correlates for deciding to start antimicrobial therapy on a patient. Predictors were status as a hospital physician (odds ratio (OR) 1.29 (95% confidence interval (CI) 1.00-1.68)), male physician (OR 1.81 (95% CI 1.42-2.31)), being age 50-59 (OR 1.56 (95% CI 1.10-2.21)), and practising in states in the former East Germany (OR 1.60 (95% CI 1.15-2.21)). Each specialist was significantly less likely to decide to start a course of antimicrobial therapy than ENTs and urologists. Other predictors were agreeing to prescribe to be on the safe side (OR 1.34 (95% CI 1.03-1.76)), believing that the quality of prescribing practice improves after receiving continuing education from pharmaceutical companies (OR 1.43 (95% CI 1.11-1.84)), and having experience with failed therapy for resistant pathogens (OR 2.42 (95% CI 1.83-3.19)). Conclusions: Physicians in our sample decide to start antimicrobial therapy on a patient, and they value intervention to support prudent use, for example continuing education, practice guidelines and implementation of surveillance measures. Socio-behavioural factors, regional variation, gender, and age merit further research to promote rational antimicrobial prescribing and explore related influencing factors.
- Subjects
GERMANY; EDUCATION of physicians; ANTIBIOTICS; ANALYSIS of variance; BEHAVIOR; CONFIDENCE intervals; REPORTING of diseases; DRUG resistance; EPIDEMIOLOGY; MULTIVARIATE analysis; PHYSICIANS; PUBLIC health surveillance; RESEARCH funding; SURVEYS; PHYSICIAN practice patterns; DATA analysis; DATA analysis software
- Publication
Infection, 2011, Vol 39, Issue 4, p289
- ISSN
0300-8126
- Publication type
Article
- DOI
10.1007/s15010-011-0137-1