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Akılcı antibiyotik kullanımı konusunda aile hekimlerinin bilgi ve yaklaşımlarının değerlendirilmesi

Year 2021, , 235 - 2412, 29.09.2021
https://doi.org/10.18663/tjcl.817750

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

References

  • 1. World Health Organization. Global Antimicrobial Resistance Surveillance System (GLASS) Report. 2017
  • 2. Harbarth S, Balkhy HH, Goossens H, et al. Antimicrobial resistance: one world, one fight. Antimicrob Resist Infect Control. 2015; 4: 49.
  • 3. Laxminarayan R, Duse A, Wattal C, et al. Antibiotic resistance—the need for global solutions. Lancet Infect Dis. 2013; 13: 1057–98.
  • 4. French GL. Clinical impact and relevance of antibiotic resistance. Adv Drug Deliv Rev. 2005 ; 57: 1514-27.
  • 5. Little P, Gould C, Williamson I, et al. Reattendance and complications in a randomised trial of prescribing strategies for sore throat: the medicalising effect of prescribing antibiotics. BMJ. 1997; 315: 350-2.
  • 6. Karatas Y, Dinler B, Erdoğdu T, et al. Evaluation of drug use attitudes of patient and its relatives attending to Cukurova University Medical faculty Balcalı Hospital. Cukurova Medical Journal. 2012; 37: 1-8.
  • 7. Antibiotic use in eastern Europe: a cross-national database study in coordination with the WHO Regional Office for Europe. Lancet Infect Dis. 2014; 14: 381-7.
  • 8. Bauman KA. The family physician’s reasonable approach to upper respiratory tract infection care for this century. Arch Fam Med. 2000; 9: 596-597.
  • 9. Gonzales R, Malone DC, Maselli JH, et al. Excessive antibiotic use for acute respiratory infections in the united states. Clin Infect Dis. 2001; 33: 757-62.
  • 10. Mangione-Smith R, McGlynn EA, Elliott MN, et al. Parent expectations for antibiotics, physician-parent communication, and satisfaction. Arch Pediatr Adolesc Med. 2001; 155: 800-6.
  • 11. Stivers T, Mangione-Smith R, Elliott MN, et al. Why do physicians think parents expect antibiotics? What parents report vs what physicians believe. J Fam Pract. 2003; 52: 140-8.
  • 12. Karabay O, Özdemir D, Güçlü E, et al. Attitudes and behaviors of Family Physicians regarding use of antibiotics. Journal of Microbiology and Infectious Diseases. 2011; 1: 53-7.
  • 13. Gonzalez-Gonzalez C, López-Vázquez P, Vázquez-Lago JM, et al. Effect of physicians attitudes and knowledge on the quality of antibiotic prescription: A Cohort study. PLoS One 2015; 10: 141820.
  • 14. Thriemer K, Katuala Y, Batoko B, et al. Antibiotic prescribing in DR congo: A knowledge, attitude and practice survey among medical doctors and students. PLoS One 2013; 8: 55495.
  • 15. Teixeira Rodrigues A, Roque F, Falcão A, et al. Understanding physician antibiotic prescribing behaviour: A systematic review of qualitative studies. Int J Antimicrob Agents. 2013; 41: 203-12.
  • 16. European Commission. Antimicrobial resistance. Eurobarometer 338/Wave 72.5-TNS Opinion and Social. Luxembourg: European Commission; 2010.
  • 17. Cadieux G, Tamblyn R, Dauphinee D, et al. Predictors of inappropriate antibiotic prescribing among primary care physicians. Can Med Assoc J. 2007; 177: 877-83.
  • 18. Høye S, Frich JC, Lindbæk M. Use and feasibility of delayed prescribing for respiratory tract infections: A questionnaire survey. BMC Fam Pract. 2011; 12: 34.
  • 19. Salm F, Schneider S, Schmücker K, et al. Antibiotic prescribing behavior among general practitioners – a questionnaire-based study in Germany. BMC Infectious Diseases. 2018; 18: 208.
  • 20. Al-Homaidan HT, Barrimah IE. Physicians’ knowledge, expectations, and practice regarding antibiotic use in primary health care. Int J Health Sci (Qassim). 2018; 12: 18-24.

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

Year 2021, , 235 - 2412, 29.09.2021
https://doi.org/10.18663/tjcl.817750

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.

References

  • 1. World Health Organization. Global Antimicrobial Resistance Surveillance System (GLASS) Report. 2017
  • 2. Harbarth S, Balkhy HH, Goossens H, et al. Antimicrobial resistance: one world, one fight. Antimicrob Resist Infect Control. 2015; 4: 49.
  • 3. Laxminarayan R, Duse A, Wattal C, et al. Antibiotic resistance—the need for global solutions. Lancet Infect Dis. 2013; 13: 1057–98.
  • 4. French GL. Clinical impact and relevance of antibiotic resistance. Adv Drug Deliv Rev. 2005 ; 57: 1514-27.
  • 5. Little P, Gould C, Williamson I, et al. Reattendance and complications in a randomised trial of prescribing strategies for sore throat: the medicalising effect of prescribing antibiotics. BMJ. 1997; 315: 350-2.
  • 6. Karatas Y, Dinler B, Erdoğdu T, et al. Evaluation of drug use attitudes of patient and its relatives attending to Cukurova University Medical faculty Balcalı Hospital. Cukurova Medical Journal. 2012; 37: 1-8.
  • 7. Antibiotic use in eastern Europe: a cross-national database study in coordination with the WHO Regional Office for Europe. Lancet Infect Dis. 2014; 14: 381-7.
  • 8. Bauman KA. The family physician’s reasonable approach to upper respiratory tract infection care for this century. Arch Fam Med. 2000; 9: 596-597.
  • 9. Gonzales R, Malone DC, Maselli JH, et al. Excessive antibiotic use for acute respiratory infections in the united states. Clin Infect Dis. 2001; 33: 757-62.
  • 10. Mangione-Smith R, McGlynn EA, Elliott MN, et al. Parent expectations for antibiotics, physician-parent communication, and satisfaction. Arch Pediatr Adolesc Med. 2001; 155: 800-6.
  • 11. Stivers T, Mangione-Smith R, Elliott MN, et al. Why do physicians think parents expect antibiotics? What parents report vs what physicians believe. J Fam Pract. 2003; 52: 140-8.
  • 12. Karabay O, Özdemir D, Güçlü E, et al. Attitudes and behaviors of Family Physicians regarding use of antibiotics. Journal of Microbiology and Infectious Diseases. 2011; 1: 53-7.
  • 13. Gonzalez-Gonzalez C, López-Vázquez P, Vázquez-Lago JM, et al. Effect of physicians attitudes and knowledge on the quality of antibiotic prescription: A Cohort study. PLoS One 2015; 10: 141820.
  • 14. Thriemer K, Katuala Y, Batoko B, et al. Antibiotic prescribing in DR congo: A knowledge, attitude and practice survey among medical doctors and students. PLoS One 2013; 8: 55495.
  • 15. Teixeira Rodrigues A, Roque F, Falcão A, et al. Understanding physician antibiotic prescribing behaviour: A systematic review of qualitative studies. Int J Antimicrob Agents. 2013; 41: 203-12.
  • 16. European Commission. Antimicrobial resistance. Eurobarometer 338/Wave 72.5-TNS Opinion and Social. Luxembourg: European Commission; 2010.
  • 17. Cadieux G, Tamblyn R, Dauphinee D, et al. Predictors of inappropriate antibiotic prescribing among primary care physicians. Can Med Assoc J. 2007; 177: 877-83.
  • 18. Høye S, Frich JC, Lindbæk M. Use and feasibility of delayed prescribing for respiratory tract infections: A questionnaire survey. BMC Fam Pract. 2011; 12: 34.
  • 19. Salm F, Schneider S, Schmücker K, et al. Antibiotic prescribing behavior among general practitioners – a questionnaire-based study in Germany. BMC Infectious Diseases. 2018; 18: 208.
  • 20. Al-Homaidan HT, Barrimah IE. Physicians’ knowledge, expectations, and practice regarding antibiotic use in primary health care. Int J Health Sci (Qassim). 2018; 12: 18-24.
There are 20 citations in total.

Details

Primary Language Turkish
Subjects Health Care Administration
Journal Section Orıgınal Artıcle
Authors

Handan Alay 0000-0002-4406-014X

Fatma Kesmez Can 0000-0001-8085-7589

Zülküf Kaya 0000-0002-9378-1672

Mahmut Ucar 0000-0003-2740-6476

Publication Date September 29, 2021
Published in Issue Year 2021

Cite

APA Alay, H., Kesmez Can, F., Kaya, Z., Ucar, M. (2021). Akılcı antibiyotik kullanımı konusunda aile hekimlerinin bilgi ve yaklaşımlarının değerlendirilmesi. Turkish Journal of Clinics and Laboratory, 12(3), 235-2412. https://doi.org/10.18663/tjcl.817750
AMA Alay H, Kesmez Can F, Kaya Z, Ucar M. Akılcı antibiyotik kullanımı konusunda aile hekimlerinin bilgi ve yaklaşımlarının değerlendirilmesi. TJCL. September 2021;12(3):235-2412. doi:10.18663/tjcl.817750
Chicago Alay, Handan, Fatma Kesmez Can, Zülküf Kaya, and Mahmut Ucar. “Akılcı Antibiyotik kullanımı Konusunda Aile Hekimlerinin Bilgi Ve yaklaşımlarının değerlendirilmesi”. Turkish Journal of Clinics and Laboratory 12, no. 3 (September 2021): 235-2412. https://doi.org/10.18663/tjcl.817750.
EndNote Alay H, Kesmez Can F, Kaya Z, Ucar M (September 1, 2021) Akılcı antibiyotik kullanımı konusunda aile hekimlerinin bilgi ve yaklaşımlarının değerlendirilmesi. Turkish Journal of Clinics and Laboratory 12 3 235–2412.
IEEE H. Alay, F. Kesmez Can, Z. Kaya, and M. Ucar, “Akılcı antibiyotik kullanımı konusunda aile hekimlerinin bilgi ve yaklaşımlarının değerlendirilmesi”, TJCL, vol. 12, no. 3, pp. 235–2412, 2021, doi: 10.18663/tjcl.817750.
ISNAD Alay, Handan et al. “Akılcı Antibiyotik kullanımı Konusunda Aile Hekimlerinin Bilgi Ve yaklaşımlarının değerlendirilmesi”. Turkish Journal of Clinics and Laboratory 12/3 (September 2021), 235-2412. https://doi.org/10.18663/tjcl.817750.
JAMA Alay H, Kesmez Can F, Kaya Z, Ucar M. Akılcı antibiyotik kullanımı konusunda aile hekimlerinin bilgi ve yaklaşımlarının değerlendirilmesi. TJCL. 2021;12:235–2412.
MLA Alay, Handan et al. “Akılcı Antibiyotik kullanımı Konusunda Aile Hekimlerinin Bilgi Ve yaklaşımlarının değerlendirilmesi”. Turkish Journal of Clinics and Laboratory, vol. 12, no. 3, 2021, pp. 235-2412, doi:10.18663/tjcl.817750.
Vancouver Alay H, Kesmez Can F, Kaya Z, Ucar M. Akılcı antibiyotik kullanımı konusunda aile hekimlerinin bilgi ve yaklaşımlarının değerlendirilmesi. TJCL. 2021;12(3):235-2412.


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