Rational prescription of antibiotics among family physicians and specialists: Attitudes and demands Aile hekimleri ve uzmanlar arasinda antimikrobiyallerin akilci reçetelendirilmesi: Tutum ve talepler
Turk Hijyen ve Deneysel Biyoloji Dergisi, cilt.71, sa.1, ss.19-26, 2014 (Scopus, TRDizin)
- Yayın Türü: Makale / Tam Makale
- Cilt numarası: 71 Sayı: 1
- Basım Tarihi: 2014
- Doi Numarası: 10.5505/turkhijyen.2014.27879
- Dergi Adı: Turk Hijyen ve Deneysel Biyoloji Dergisi
- Derginin Tarandığı İndeksler: Scopus, TR DİZİN (ULAKBİM)
- Sayfa Sayıları: ss.19-26
- Anahtar Kelimeler: Antibiotic, Attitude, Medical doctor
- Sağlık Bilimleri Üniversitesi Adresli: Evet
Özet
Objective: This study aims to investigate the conditions and the factors affecting clinicians in prescription of antibiotic medicines. In this way, some of the policies to combat with the development of antibiotic resistance will be appointed and the measurement of the efficiency of the measures would be possible. Methods: For the study, 8 provinces have been selected from 12 region of Nomenclature of Territorial Units for Statistics according to Turkish Statistical Institute, which were Edirne, Manisa, Sakarya, Ankara, Mersin, Nevsehir, Trabzon and Elazig. From each province 10 specialist and 10 family physician were included with a total of 160 clinicians. A questionnaire containing 33 questions had applied to them, and the data was analyzed with SPSS 15.0. Results: Of the physicians's, 82.9% were from urban area, 69.2% from 36 to 50 years age group and 66.3% were males. The average number of patients who were examined was 238.2 ± 123.0 persons per week. It was indicated that antibiotic prescriptions were written 69.5 ± 55.7 people, 67.0 ± 56.9 box and 6.5 ± 1.5 days per week. Not writing any prescription/antibiotics for each patient examined were 78.0% and 97,5%, respectively. The most frequently written antibiotics were penicillins (67.8%), cephalosporins (36.3%) and macrolids (13.8%). Not using guidelines about diagnosis and therapy was 69.2%. The previous experience and knowledge influenced the decision of prescribing antibiotics by 61.7%, and the goal was stated as treatment by 91.56%. The clinicians who replied to the questionnaire told that when it was requested to prescribe antibiotic by the patient, if it was related with his disease 86.7%, if it was for keeping at home, 93.1% were not to be prescribed. Before prescription of antibiotic, 84.8% laboratory test are requested, selection of antibiotic was depended on clinical findings of the patient by 98.11%, and to adjust the dose of antibiotic age of the patient is said to be effective by 90.62%. The top three complaints of patients prescribed antibiotic were fever (83.64%), urinary tract complaints (73.58%), and sore throat (47.79%). Clinicians declared that they had received drug/antibiotic usage training during undergraduation by 52.5%; postgraduation by 67.9%; they received training from a university by 63.1%; and 60.0% of them said they want to receive training. The ones who want to receive training wanted to receive it from infectious disease specialist by 36.4%; from a university by 30.9%; from Ministry of Health by 22.3%. The frequency of antibiotic prescription is declared to be low by the clinicians. On the other hand, ratio of usage of guidelines is low and there is need to take measures and planning of training to increase it. Clinicians declare that they request laboratory tests, but the laboratory results doesn't influence their antibiotic drug selection. Conclusion: The choice of the antibiotic is a major concern for the struggle of resistance development. For empirical treatment resistance rates in that region should be kept in mind and priority should be given to the first choice drugs, and the treatment should be revised according to the result of patient-specific antibiotic susceptibility testing. For the detection of region-specific resistance rates in our country, the data of the National Antibiotic Resistance Surveillance System that has been established can be used. In order to explain the situation to medical doctors, guidelines and activities such as the European Antibiotic Awareness Day campaigns should be utilized. Undergraduate and postgraduate rational drug/antibiotic usage trainings and evidencebased medical practices of physicians should be increased.