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Over prescribing of antibiotics for acute respiratory tract infections; a qualitative study to explore Irish general

Jane O'Doherty1, Leonard F W Leader2, Andrew O'Regan3

  • 1Graduate Entry Medical School, University of Limerick, Limerick, Ireland. Jane.ODoherty@ul.ie.

BMC Family Practice
|February 16, 2019
PubMed
Abstract

Insights

General practitioners (GPs) often prescribe antibiotics for acute respiratory tract infections (ARTIs) due to non-comprehensive guidelines and patient pressure. Changing patient expectations is crucial to combatting antimicrobial resistance (AMR).

Area of Science:

  • General Practice
  • Public Health
  • Infectious Diseases

Background:

  • Antimicrobial resistance (AMR) is a significant global health threat.
  • Antibiotics are frequently overprescribed for acute respiratory tract infections (ARTIs) in primary care settings.
  • Understanding the reasons behind antibiotic overprescription is vital for effective AMR stewardship.

Purpose of the Study:

  • To explore the factors influencing general practitioners' (GPs) decisions to prescribe antibiotics for ARTIs.
  • To investigate the perceived barriers to guideline adherence in antibiotic prescribing.
  • To identify potential interventions to reduce unnecessary antibiotic use in general practice.

Main Methods:

  • Qualitative explorative study design.
  • Purposive sampling of thirteen GPs from diverse settings in the Mid-West of Ireland.
  • Semi-structured interviews, digitally recorded and transcribed for thematic analysis.

Main Results:

  • Three key themes emerged: challenges with guideline implementation, external pressures from patients, and the issue of unnecessary prescribing.
  • GPs found clinical guidelines difficult to apply in real-world practice.
  • Patient expectations and perceived pressure to prescribe, particularly for fee-paying patients and in out-of-hours settings, were significant factors.

Conclusions:

  • GPs recognize the need to change prescribing behaviors to mitigate AMR.
  • Interventions should address both clinical practice and public perceptions regarding antibiotic use.
  • Modifying patient expectations is essential for reducing unnecessary antibiotic prescriptions for ARTIs.
Keywords:
Acute respiratory tract infectionsAntibiotic resistanceAntibioticsGeneral practice

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