Chamany Shadi, Schulkin Jay, Rose Charles E, Riley Laura E, Besser Richard E
Epidemic Intelligence Service, Division of Applied Public Health Training, Epidemiology Program Office, Centers for Disease Control and Prevention (CDC), Atlanta, GA, USA.
Infect Dis Obstet Gynecol. 2005 Mar;13(1):17-24. doi: 10.1080/10647440400025579.
Knowledge, attitudes, and practices regarding antibiotic prescribing for upper respiratory tract infections (URIs) have not been well described among obstetrician-gynecologists (OB/GYNs). This information is useful for determining whether an OB/GYN-specific program promoting appropriate antibiotic use would significantly contribute to the efforts to decrease inappropriate antibiotic use among primary care providers.
An anonymous questionnaire asking about the treatment of URIs was sent to 1031 obstetrician-gynecologists.
The overall response rate was 46%. The majority of respondents (92%) were aware of the relationship between antibiotic use and antibiotic resistance, and respondents estimated that 5% of their patients had URI symptoms at their office visits. Overall, 56% of respondents reported that they would prescribe an antibiotic for uncomplicated bronchitis and 43% for the common cold. OB/GYNs with the fewest years of experience were less likely than those with the most years of experience to report prescribing for uncomplicated bronchitis (Odds ratio (OR) 0.46, 95% confidence interval (CI) 0.23 to 0.91) or the common cold (OR 0.44, CI 0.22 to 0.89). The majority of respondents (60%) believed that most patients wanted an antibiotic for URI symptoms, with male OB/GYNs being more likely than female OB/GYNs (OR 2.1, CI 1.2 to 3.8) to hold this belief. Both male OB/GYNs (OR 1.9, CI 1.1 to 3.4) and rural practitioners (OR 2.1, CI 1.1 to 4.0) were more likely to believe that it was hard to withhold antibiotics for URI symptoms because other physicians prescribe antibiotics for these symptoms. OB/GYNs who believed that postgraduate training prepared them well for primary care management were more likely than those who did not (OR 2.1, CI 1.1 to 4.2) to believe that they could reduce antibiotic prescribing without reducing patient satisfaction.
Multiple demographic factors affect attitudes and reported practices regarding antibiotic prescribing. However, in view of the low proportion of office visits for URIs, an OB/GYN-specific program is not warranted.
在妇产科医生中，关于上呼吸道感染（URI）抗生素处方的知识、态度和做法尚未得到充分描述。这些信息有助于确定针对妇产科医生的促进合理使用抗生素的项目是否会对减少初级保健提供者中不合理使用抗生素的努力做出重大贡献。
向1031名妇产科医生发送了一份关于URI治疗的匿名问卷。
总体回复率为46%。大多数受访者（92%）了解抗生素使用与抗生素耐药性之间的关系，受访者估计其门诊患者中有5%出现URI症状。总体而言，56%的受访者表示会为单纯性支气管炎开抗生素，43%会为普通感冒开抗生素。经验最少的妇产科医生比经验最丰富的医生为单纯性支气管炎开处方的可能性更小（优势比（OR）0.46，95%置信区间（CI）0.23至0.91），为普通感冒开处方的可能性也更小（OR 0.44，CI 0.22至0.89）。大多数受访者（60%）认为大多数患者因URI症状想要使用抗生素，男性妇产科医生比女性妇产科医生更有可能持有这种观点（OR 2.1，CI 1.2至3.8）。男性妇产科医生（OR 1.9，CI 1.1至3.4）和乡村医生（OR 2.1，CI 1.1至4.0）都更有可能认为很难不为URI症状开具抗生素，因为其他医生会为这些症状开抗生素。认为研究生培训使其为初级保健管理做好充分准备的妇产科医生比那些不这样认为的医生更有可能（OR 2.1，CI 1.1至4.2）相信他们可以在不降低患者满意度的情况下减少抗生素处方。
多种人口统计学因素影响抗生素处方的态度和报告的做法。然而，鉴于URI门诊就诊比例较低，无需开展针对妇产科医生的项目。
