Kaplan Nasser M, Khader Yousef S, Alfaqih Mahmoud A, Saadeh Rami, Al Sawalha Lora
Department of Pathology and Microbiology, Faculty of Medicine, Jordan University of Science and Technology, 22110 Irbid, Jordan.
Department of Community Medicine and Public Health, Faculty of Medicine, Jordan University of Science and Technology, 22110 Irbid, Jordan.
Antibiotics (Basel). 2020 Aug 12;9(8):507. doi: 10.3390/antibiotics9080507.
The misuse of antibiotics is a worldwide public health concern. Behavioral Intervention programs that aim to reduce patients' own request for antibiotics during their visit to primary care clinics is an attractive strategy to combat this problem. We tested the effectiveness of a behavioral modification method known as the Tailoring Antimicrobial resistance Programs (TAP) in reducing the request for antibiotics by patients visiting primary care clinics for mild upper respiratory tract infections (URTIs). A stratified cluster randomized design with two groups pre-post, comparing intervention with the control, was conducted in six health centers. TAP was implemented for eight weeks. Request for antibiotics was assessed before (period 1) and after introducing TAP (period 2). The percentage of patients or their escorts who requested antibiotics in period 1 was 59.7% in the control group and 60.2% in the intervention group. The percentage of patients who requested antibiotics did not significantly change between period 1 and 2 in the control group, who continued to receive the standard of care. The above percentage significantly decreased in the intervention group from 60.2% to 38.5% ( < 0.05). We conclude that behavioral change programs including TAP are a viable alternative strategy to address antibiotic misuse in Jordan.
抗生素的滥用是一个全球性的公共卫生问题。旨在减少患者在就诊于基层医疗诊所期间自行要求使用抗生素的行为干预项目，是应对这一问题的一项颇具吸引力的策略。我们测试了一种名为“定制抗微生物耐药性项目”（TAP）的行为改变方法，在减少因轻度上呼吸道感染（URTIs）就诊于基层医疗诊所的患者对抗生素的需求方面的有效性。在六个健康中心进行了一项分层整群随机设计，分为两组，每组在干预前后进行对比，将干预组与对照组进行比较。TAP实施了八周。在引入TAP之前（第1阶段）和之后（第2阶段）评估对抗生素的需求。在第1阶段，对照组中要求使用抗生素的患者或其陪同人员的比例为59.7%，干预组为60.2%。在继续接受标准护理的对照组中，第1阶段和第2阶段之间要求使用抗生素的患者比例没有显著变化。在干预组中，上述比例从60.2%显著下降至38.5%（<0.05）。我们得出结论，包括TAP在内的行为改变项目是解决约旦抗生素滥用问题的一种可行替代策略。
