Hastalar Neden Antibiyotik İster ve Hekimler Neden Antibiyotik Reçete Eder?: Birinci Basamakta Kesitsel Bir Çalışma

Year 2019, Volume: 19 Issue: 1, 133 - 142, 22.03.2019

Feride Derya Şarklı Aylin Baydar Artantaş , Mehmet Uğurlu

https://doi.org/10.17098/amj.542209

Cited By: 4

Abstract

Amaç:
Antibiyotiklerin uygunsuz kullanımı dünya çapında bir halk sağlığı sorunudur.
Ne yazık ki, Türkiye özellikle yüksek oranda antibiyotik reçetesi ile olumsuz
bir üne sahiptir. Bu çalışmanın amacı, Türkiye’deki birinci basamak
hekimlerinin antibiyotik reçete etmelerinde etkili olan faktörleri belirlemek
ve hekimlerin akılcı antibiyotik kullanımı konusundaki bilgi düzeylerini
değerlendirmektir.

Materyal ve Metot: Bu kesitsel
çalışma, Ankara ilinde 8 farklı ilçedeki Aile Sağlığı Merkezleri ve Toplum
Sağlığı Merkezleri'nde gerçekleştirildi. Hekimlere bilgi düzeylerini ve akılcı
antibiyotik kullanımı ile ilgili tutumlarını değerlendirmek için, kendilerinin
cevaplayacağı bir anket uygulandı. Elde edilen veriler SPSS 21.0 yazılımı
kullanılarak analiz edildi.

Bulgular: Çalışmaya 84 (%42) erkek
ve 116 (%58) kadın olmak üzere 200 doktor katıldı. Hekimlerin %38,5'i
hastaların antibiyotik isteğini reddetmiş olduklarını belirttiler. 11 yıl ve
daha uzun süredir hekimlik yapanların “hastanın beklenti ve ısrarı”ndan
etkilendiği görülürken, 10 yıl ve daha az süredir çalışanların “eşlik eden
hastalık varlığı” ndan etkilendiği görüldü. (p1=0,044, p2=0,012). Hekimlerin
antibiyotiklerle ilgili en çok antimikrobiyal direnç ve maliyet konularında
bilgi eksiklikleri olduğu saptandı. 

Sonuç: Antibiyotiklerin rasyonel
kullanımı açısından, hekimlerinin antibiyotikler ve antibiyotiklerin akılcı
kullanımı ile ilgili bilgi düzeyi ve bunların antibiyotik reçeteleme
davranışları ile ilişkisi son derece önemlidir. Bu nedenle, toplumda uygun olmayan
antibiyotik kullanımını önlemek açısından gereksiz antibiyotik reçetelenmesine
neden olan faktörlerin ortaya çıkarılması önemlidir. 

Keywords

Akılcı antibiyotik kullanımı, birinci basamak, aile hekimi

Why Do Patients Want Antibiotics and Why Do Physcians Prescribe Antibiotics?: A Cross-Sectional Study In Primary Health Care

Abstract

Objectives: The
inappropriate use of antibiotics is a worldwide public healthcare problem.
Unfortunately, Turkey has a negative reputation with a particularly high rate
of antibiotic prescription. The aim of this study is to determine the factors
affecting Turkish primary care physicians in prescribing antibiotics and to
evaluate the knowledge levels of the physicians on the rational use of
antibiotics.

Materials and Methods: This cross -
sectional study was carried out in Family Health Centers and Community Health
Centers in 8 different districts in Ankara. A self-reporting questionnaire was
administered to the physicians to evaluate their level of knowledge and
attitudes towards the rational use of antibiotics. The data obtained were
analysed using SPSS 21.0 software. 

Results: The study included 200 physicians,
comprising 84 (42%) males and 116 (58%) females. Of the total physicians, 38.5%
stated that they had refused patient’s request for antibiotics. Those who had
been working for ≥11 years were seen to be affected by ‘the patient’s
expectations and insistence’ when prescribing antibiotics and those working for
≤10 years by ‘the presence of comorbid disease’ (p1=0.044, p2=0.012). The
subjects on which the physicians were most lacking in knowledge related to
antibiotics were determined to be antimicrobial resistance and cost. 

Conclusion: In terms of the rational
use of antibiotics, physicians’ knowledge level about antibiotics and rational
use of antibiotics and their associated behaviour in prescribing antibiotics
are extremely important. Therefore, it is important to identify the factors
that cause unnecessary antibiotic prescription in order to prevent
inappropriate antibiotic use in the population.

Keywords

Rational use of antibiotics, primary care, family physician

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