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卡塔尔上呼吸道感染抗菌药物使用的知识、态度、认知与实践:一项系统综述

Knowledge, attitude, perception and practice regarding antimicrobial use in upper respiratory tract infections in Qatar: a systematic review.

作者信息

Shaikhan F, Rawaf S, Majeed A, Hassounah S

机构信息

WHO Collaborating Centre for Public Health Education and Training, Department of Primary Care and Public Health, Imperial College London, London, UK.

Department of Primary Care and Public Health, Imperial College London, London, UK.

出版信息

JRSM Open. 2018 Sep 3;9(9):2054270418774971. doi: 10.1177/2054270418774971. eCollection 2018 Sep.

Abstract

OBJECTIVE

To explore the knowledge, attitude, perception and practice towards antimicrobial use in upper respiratory tract infections in patients visiting healthcare settings in Qatar.

DESIGN

Systematic review was performed using a predetermined protocol and in accordance with standardized reporting guidelines. MEDLINE, PubMed, EMBASE, Global Health and PsycINFO were searched for relevant published studies using relevant MESH terms and keywords.

SETTING

All healthcare settings in Qatar including both inpatient and ambulatory care.

PARTICIPANTS

All published articles exploring the antimicrobial use in upper respiratory tract infections at any health setting in Qatar were considered for inclusion in the study. No age, gender or population were excluded.

MAIN OUTCOME MEASURES

The outcome of interest was antimicrobial use in upper respiratory tract infections in Qatar. We included all related studies to explore the knowledge, attitude, perception and practice for patients visiting all health care settings.

RESULTS

Three articles were included, one in a primary care setting, one in a secondary care setting and one in the private sector. Overprescribing was noted in all settings. Our findings demonstrate low expectations to receive antibiotics, among the Qatari population, in primary care (28.1%). In fact, the majority of patients would be satisfied with reassurance rather than receiving antimicrobials. Many patients were satisfied with explanation from physicians and counselling. Private sector registered high prevalence of antimicrobial misuse for respiratory tract infections in which 85% deemed inappropriate. This finding was also noted at a medical intensive care unit which showed high antimicrobial use (76%) and respiratory tract infections accounted for 57% of prescriptions.

CONCLUSION

Studies are needed to determine factors and population-based rates of antimicrobial use in all healthcare settings. There is also a need for interventional programs for both physicians and public on appropriate use of antimicrobials to combat global antimicrobial resistance.

摘要

目的

探讨卡塔尔医疗机构就诊患者对上呼吸道感染使用抗菌药物的知识、态度、认知和行为。

设计

采用预先制定的方案并按照标准化报告指南进行系统评价。使用相关医学主题词和关键词在MEDLINE、PubMed、EMBASE、全球卫生和PsycINFO中检索相关发表的研究。

地点

卡塔尔所有医疗机构,包括住院和门诊护理机构。

参与者

所有探索卡塔尔任何卫生机构上呼吸道感染抗菌药物使用情况的已发表文章均被纳入本研究。不排除任何年龄、性别或人群。

主要观察指标

感兴趣的结果是卡塔尔上呼吸道感染抗菌药物的使用情况。我们纳入了所有相关研究,以探讨所有医疗机构就诊患者的知识、态度、认知和行为。

结果

纳入了三篇文章,一篇来自基层医疗环境,一篇来自二级医疗环境,一篇来自私营部门。所有环境中均存在过度处方现象。我们的研究结果表明,卡塔尔人群在基层医疗中对抗生素治疗的期望较低(28.1%)。事实上,大多数患者对得到安慰而非接受抗菌药物治疗会感到满意。许多患者对医生的解释和咨询感到满意。私营部门呼吸道感染抗菌药物滥用的患病率较高,其中85%被认为是不适当的。这一发现也在一个医疗重症监护病房中得到证实,该病房抗菌药物使用率较高(76%),呼吸道感染占处方的57%。

结论

需要开展研究以确定所有医疗机构中抗菌药物使用的因素和基于人群的使用率。还需要针对医生和公众开展关于合理使用抗菌药物的干预项目,以应对全球抗菌药物耐药性问题。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/8245/6122249/ed9c3559d17d/10.1177_2054270418774971-fig1.jpg

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