Lam T P, Lam K F
Family Medicine Unit, Department of Medicine, The University of Hong Kong.
Int J Clin Pract. 2003 Apr;57(3):167-9.
The prescribing behaviour of family doctors in Hong Kong towards upper respiratory tract infections (URTIs), and the major clinical factors that might affect such behaviour, were studied. Members of the Hong Kong College of Family Physicians were surveyed; 801 completed the questionnaire with an overall response rate of 65%. Purulent nasal discharge, purulent sputum, persistent fever over three days, patients looking unwell, exudates on throat, inflamed eardrums and cervical lymphadenopathy made more than half the respondents 'likely' or 'very likely' to prescribe antibiotics. Those in private practice and those who graduated in Hong Kong were more likely to prescribe antibiotics, while fellows of the College were less likely to do so. Vocational training and higher qualifications in family medicine/general practice, however, revealed minimal effect. Our results showed that many doctors are still prescribing antibiotics when they encounter URTI patients presenting with clinical factors that have been proven to have no or little benefit from antibiotics.
本研究探讨了香港家庭医生对上呼吸道感染（URTIs）的处方行为，以及可能影响该行为的主要临床因素。对香港家庭医生学院的成员进行了调查；801人完成了问卷，总体回复率为65%。脓性鼻涕、脓性痰、持续发热超过三天、患者看起来不适、咽喉部渗出物、鼓膜发炎和颈部淋巴结肿大，使超过一半的受访者“可能”或“非常可能”开具抗生素。私人执业医生和在香港毕业的医生更有可能开具抗生素，而该学院的院士则不太可能这样做。然而，家庭医学/全科医学的职业培训和更高学历显示出的影响极小。我们的结果表明，当遇到出现已被证明使用抗生素无益处或益处不大的临床因素的上呼吸道感染患者时，许多医生仍在开具抗生素。
