Akılcı antibiyotik kullanımı konusunda aile hekimlerinin bilgi ve yaklaşımlarının değerlendirilmesi

Abstract

Amaç: Akılcı olmayan antibiyotik kullanımı sonucu ortaya çıkan antimikrobiyal direnç, tüm dünyada ve ülkemizde giderek artan önemli bir halk sağlığı sorunudur. Hastaya bağlı faktörlerin yanında hekimlerin antibiyotik reçete etme konusundaki bilgi ve tutumları akılcı olmayan antibiyotik kullanımını artırmaktadır. Bu çalışmada amacımız ilimizdeki aile hekimlerinin antibiyotik reçete etme konusundaki bilgi, tutum ve davranışlarını belirleyerek akılcı antibiyotik kullanımı konusunda hekimlerin farkındalığını artırmaktır. Gereç ve Yöntemler: Hekimlerin antibiyotik reçete etmedeki bilgi düzeyleri ve davranışları konusunda 19 sorudan oluşan anket formu oluşturuldu. 29.12.2018-01.05.2019 tarihleri arasında 180 aile hekimi anketi doldurmayı kabul etti. Bulgular: Aile hekimlerinin 106 (%58,9)’u erkek, 74 (%41,1)’i kadındı. Yaş ortalamaları 33± 1 (min: 24- max: 50) yıl ve ortalama hizmet süreleri 103±1 (min:1–max:300) ay idi. Hekimlerin günlük hasta sayısı ortalaması 77±1 idi. Hekimlerin 137 (%76,1)’i il merkezinde, 43 (%23,9)’u ilçede görev yapmaktaydı. Hekimlerin en sık karşılaştıkları enfeksiyon tipleri 134 (%37.5) üst solunum yolu enfeksiyonu ve 61(%17.1) üriner sistem enfeksiyonu idi. En sık reçete ettikleri antibiyotikler beta laktam grubu antibiyotikler idi. Hekimlerin 109 (%60.6)’u mezuniyet sonrası eğitim almadıklarını, 147(%81.7)’si akılcı antibiyotik kullanımı konusunda mezuniyet sonrası hizmet içi eğitimlerin faydalı olduğunu belirttiler. Hekimlerin 93 (%51.7)’ü antibiyotik reçete ederken baskı altında hissettiklerini ifade etti. İl merkezi ve ilçelerde çalışan hekimlerimizi antibiyotik reçete etmelerini etkileyen faktörler açısından karşılaştırdığımızda, il merkezindeki hekimlerin antibiyotik reçete ederken daha çok baskı altında hissettiklerini tespit ettik (p>0.05). Sonuç: Doktorların akılcı antibiyotik kullanımı hakkındaki bilgi, tutum ve davranışlarını anlamak, akılcı antibiyotik reçete etmeleri için oldukça önemlidir. Mezuniyet sonrası eğitim çalışmaları, hekimlerin antibiyotik reçete etmelerinde olumlu iyileştirmeler sağlayacaktı

Keywords

• Akılcı antibiyotik kullanımı,
• antibiyotik,
• aile hekimi,
• reçete yazma,
• antimikrobiyal direnç,

Evaluation of knowledge and approaches of family physicians on rational antibiotic use

Abstract

Aim: Antimicrobial resistance resulting from non-rational use of antibiotics is a growing public health problem in Turkey and worldwide. In addition to patient-related factors, physicians’ knowledge of and attitudes toward prescribing antibiotics also contribute to non-rational antibiotic use. The purpose of our study is to enhance physician awareness of rational use of antibiotics by determining the knowledge of and attitudes and behaviors toward antibiotic prescription of family physicians in our province. Material and Methods: A 19-item questionnaire was prepared to investigate physicians’ levels of knowledge and behaviors regarding antibiotic prescription. One hundred eighty physicians agreed to complete the questionnaire between 29.12.2018 and 01.05.2019. Results: One hundred six (58.9%) physicians were men and 74 (41.1%) were women. Their mean age was 33±1 (min 24, max 50) years, and their mean length of service was 103±1 (min 1, max 300) months. The mean number of patients seen in a day was 77±1. One hundred thirty-seven (76.1%) physicians were working in the province and 43 (23.9%) in outlying districts. The most commonly encountered infection types were upper respiratory tract infections, reported by 134 (37.5%), and urinary tract infections, reported by 61 (17.1%). The most commonly prescribed antibiotics were beta lactam group drugs. One hundred nine physicians (60.6%) reported receiving no training on rational antibiotic use after graduation, while 147 (81.7%) described postgraduate in-service training seminars on rational use of antibiotics as useful. Ninety-three (51.7%) reported feeling pressurized when issuing antibiotic prescriptions. Comparison of the physicians working in the province and in outlying districts in terms of antibiotic prescription behavior revealed that those in the province were felt more pressure while prescribing antibiotics (p>0.05). Conclusion: Understanding physicians’ knowledge of and attitudes and behaviors toward rational antibiotic use is important in terms of their rational antibiotic prescription behavior. Postgraduate educational seminars will have a positive impact on rational antibiotic prescription.

Keywords

• Rational antibiotic use
• antibiotic
• family physicians
• antimicrobial resistance

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