Between Patient Pressure and Professional Responsibility: Antibiotic Prescribing Practices in Primary Care

Area of Science:

• Public Health
• Infectious Diseases
• General Practice

Background:

• Antimicrobial resistance (AMR) is a critical global health threat, exacerbated by inappropriate antibiotic prescribing.
• General practitioners (GPs) in Hungary are primary prescribers, yet the interplay between patient expectations and their prescribing behavior is under-researched.

Purpose of the Study:

• To investigate the antibiotic prescribing practices of Hungarian general practitioners.
• To explore GPs' perceptions of patient expectations regarding antibiotic prescriptions.
• To assess current antimicrobial stewardship practices among GPs in Hungary.

Main Methods:

• A cross-sectional study involving 181 GPs in Hungary (March 2024-April 2025).
• Anonymous paper-based questionnaires assessed knowledge, perceived patient expectations, prescribing behavior, and stewardship.
• The sample was representative of the northeastern region of Hungary.

Main Results:

• While 81.7% recognized AMR as a major issue, only 52.2% felt capable of combating it.
• 80.6% reported patient expectations for antibiotics, and 71.1% faced prescribing conflicts, yet 87.2% stated they do not yield to pressure.
• Concerning practices included patient-initiated courses (56.1%), 'just-in-case' prescribing (36.1%), and encountering self-medication (38.9%). Only 17.8% regularly monitored prescribing indicators.

Conclusions:

• Hungarian GPs show resilience against patient pressure but engage in 'just-in-case' prescribing and face self-medication issues, indicating antimicrobial stewardship vulnerabilities.
• Targeted, multifaceted interventions are necessary to address prescriber behavior and systemic factors to enhance antimicrobial stewardship.