Velasco Edward, Ziegelmann Antina, Eckmanns Tim, Krause Gérard
Department for Infectious Disease Epidemiology, Robert Koch Institute, Berlin, Germany.
BMJ Open. 2012 Feb 3;2(1):e000398. doi: 10.1136/bmjopen-2011-000398. Print 2012.
To better understand physicians' views on factors of influence for the prescribing of antibiotics and on antibiotic resistance in the Berlin region, Germany.
Qualitative study with focus groups.
Outpatient care and hospital care practice in the Berlin region, Germany.
7 General practitioners, two urologists, one paediatrician from outpatient care and eight internists, two paediatricians, two ear, nose and throat specialists and two urologists from hospital care.
Physicians showed differential interest in topics related to antibiotic prescribing and antibiotic resistance. Outpatient care physicians were interested in topics around their own prescribing, such as being able to diagnose and prescribe precisely, and topics about patient demand and non-compliance. Hospital care physicians were interested in hygiene challenges, limited consult time and multi-resistant pathogens.
Physicians considered the development of resistance to be more in the domain of clinical treatment than that of the patient. Major challenges related to antibiotic resistance for this group of physicians are access to and clarity of treatment recommendations, implementation of hygienic measures, as well as increased outsourcing of laboratory services. Results raise questions about whether meeting physicians' expectations should be a focus when developing intervention that aims to influence antibiotic resistance in this and other areas of Germany.
为了更好地了解德国柏林地区医生对抗生素处方影响因素及抗生素耐药性的看法。
焦点小组定性研究。
德国柏林地区的门诊护理和医院护理实践。
7名全科医生、2名泌尿科医生、1名门诊护理儿科医生、8名内科医生、2名儿科医生、2名耳鼻喉科专家以及2名医院护理泌尿科医生。
医生们对抗生素处方和抗生素耐药性相关话题表现出不同的兴趣。门诊护理医生对与自身处方相关的话题感兴趣，比如能够准确诊断和开出处方，以及关于患者需求和不依从性的话题。医院护理医生对卫生挑战、有限的会诊时间和多重耐药病原体感兴趣。
医生们认为耐药性的发展更多地属于临床治疗范畴而非患者范畴。这群医生在抗生素耐药性方面面临的主要挑战包括治疗建议的可获取性和清晰度、卫生措施的实施以及实验室服务外包的增加。研究结果引发了这样的疑问：在制定旨在影响德国这个地区及其他地区抗生素耐药性的干预措施时，满足医生的期望是否应成为重点。
