Wushouer Haishaerjiang, Wang Zhuangfei, Tian Ye, Zhou Yue, Zhu Dawei, Vuillermin Daniel, Shi Luwen, Guan Xiaodong
Center for Strategic Studies, Chinese Academy of Engineering.
School of Medicine, Tsinghua University.
Medicine (Baltimore). 2020 Jan;99(3):e18852. doi: 10.1097/MD.0000000000018852.
We designed this study to explore how factors, especially knowledge, influence the use and prescriptions of antibiotics among physicians in China's county hospitals.A questionnaire was designed to evaluate the knowledge levels of physicians. The rates of antibiotic prescriptions were collected through on-the-spot investigations. The percentage of encounters with antibiotics prescribed and the percentage of encounters with antibiotics combination prescribed were used to measure antibiotics use. Univariate analysis and the generalized linear model were applied to analyze the knowledge levels among physicians as well as their antibiotic prescriptions.A total of 334 physicians in 60 county hospitals filled out the questionnaires, and 385,529 prescriptions were collected. The mean score of the questionnaire was a pass (62.8). The physicians in the eastern region of China demonstrated higher levels of knowledge than other regions (P = .08). Physicians with a higher score prescribed less antibiotics (P < .01) and less antibiotics combination (P = .07).The knowledge gap of Chinese physicians is evident and those with a higher degree of knowledge always prescribe fewer antibiotics. Targeted training and courses to educate physicians about the risks of over-prescription of antibiotics should be conducted to improve the practice of antibiotic prescriptions.
我们开展这项研究旨在探究各种因素，尤其是知识，如何影响中国县级医院医生对抗生素的使用及处方开具情况。设计了一份问卷来评估医生的知识水平。通过实地调查收集抗生素处方率。使用开具抗生素的诊疗次数百分比以及联合使用抗生素的诊疗次数百分比来衡量抗生素的使用情况。运用单因素分析和广义线性模型来分析医生的知识水平及其抗生素处方情况。60家县级医院的334名医生填写了问卷，并收集到385,529份处方。问卷平均得分及格（62.8分）。中国东部地区的医生知识水平高于其他地区（P = 0.08）。得分较高的医生开具的抗生素较少（P < 0.01）且联合使用抗生素的情况较少（P = 0.07）。中国医生的知识差距明显，知识水平较高的医生开具的抗生素总是较少。应开展针对性培训和课程，向医生传授抗生素过度处方的风险知识，以改善抗生素处方行为。
