Hungarian general practice paediatricians' antibiotic prescribing behaviour for suspected respiratory tract
Balázs Babarczy1,2, Ágnes Hajdu2, Ria Benko3
1Syreon Research Institute, Budapest, Hungary.
Insights
Paediatric general practitioners in Hungary sometimes prescribe antibiotics that contribute to antimicrobial resistance (AMR), despite efforts towards more prudent prescribing. Gaps in knowledge and communication need addressing to combat AMR effectively.
Area of Science:
- Medical Research
- Public Health
- Infectious Diseases
Background:
- Inappropriate antibiotic prescribing is a primary driver of antimicrobial resistance (AMR).
- Understanding physician prescribing behavior is crucial for developing effective AMR containment strategies.
Purpose of the Study:
- To explore the antibiotic prescription practices of paediatric general practitioners (GPs) in Hungary for suspected respiratory tract infections (RTIs).
- To analyze these practices through the lens of the capability-opportunity-motivation-behaviour (COM-B) framework.
Main Methods:
- A qualitative study design was employed, utilizing individual, semi-structured telephone or virtual interviews.
- Twenty-two paediatric general practitioners (GPs) from diverse age, sex, and geographical backgrounds in Hungary were interviewed.
- Stratified maximum variation sampling ensured representation across different prescription rate areas.
Main Results:
- GPs' prescribing decisions are influenced by personal experience, physical examination, and a holistic approach to child health, including social factors and parental preferences.
- Some GPs expressed confidence in their therapeutic choices, even when acknowledging potential contributions to AMR development.
- While some perceived a decrease in antibiotic prescription frequency, a gap in knowledge regarding antibiotics and AMR was noted among both physicians and the public.
Conclusions:
- A trend towards more prudent antibiotic prescribing may be emerging, yet significant knowledge and awareness gaps persist.
- Hungary's national action plan for AMR needs implementation, coupled with enhanced professional communication and feedback mechanisms for primary care physicians.
- Addressing these gaps is essential to reinforce awareness and mitigate the growing threat of antimicrobial resistance.
Objectives:
Inappropriate antibiotic prescribing is a major cause of antimicrobial resistance (AMR). The aim of this study was to explore paediatric general practitioners' (GP Peds) antibiotic prescription practice in suspected respiratory tract infections (RTIs), using the capability-opportunity-motivation-behaviour framework.
Design:
The design is a qualitative study based on individual, semistructured telephone or virtual interviews.
Setting:
Paediatric general practice in Hungary. We applied stratified maximum variation sampling to cover the categories of age, sex and geographical location of participants.
Participants:
We interviewed 22 GP Peds. Nine were male and 13 were female: 2 of them were less than 40 years old, 14 were between 40 and 60 years, and 6 were above 60 years. 10 worked in low-antibiotic prescription areas, 5 in areas with medium levels of antibiotic prescription, 3 in high-antibiotic prescription areas, and 4 in and around the capital city.
Results:
Study participants had varying antibiotic prescription preferences. Personal experience and physical examination play a central role in GP Peds' diagnostic and treatment practice. Participants emphasised the need to treat children in their entirety, taking their personal medical record, social background and sometimes parents' preferences into account, besides the acute clinical manifestation of RTI. Most respondents were confident they apply the most effective therapy even if, in some cases, this meant prescribing medicines with a higher chance of contributing to the development of AMR. Some participants felt antibiotic prescription frequency has decreased in recent years.
Conclusions:
Our findings suggest that a more prudent attitude toward antibiotic prescribing may have become more common but also highlight relevant gaps in both physicians' and public knowledge of antibiotics and AMR. To reinforce awareness and close remaining gaps, Hungary should adopt its national AMR National Action Plan and further increase its efforts towards active professional communication and feedback for primary care physicians.
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