Department of Public Health, General Practice, University of Southern Denmark, Odense, Denmark.
Health Centre Via Roma, University Institute in Primary Care Research Jordi Gol i Gurina, CIBER de Enfermedades Infecciosas, Instituto de Salud Carlos III, Barcelona, Spain.
Eur J Gen Pract. 2022 Dec;28(1):217-223. doi: 10.1080/13814788.2022.2130887.
A doctor may recommend that a patient stop an antibiotic course before its scheduled completion time if further treatment may cause more harm than benefit.
This study explores general practitioners' (GP) opinions about the use of antibiotic deprescribing (AD) in general practice.
A cross-sectional, questionnaire-based study answered from February to March 2022. GPs ( = 6,083) affiliated with the largest Spanish scientific society of primary care were invited to participate. The survey included two statements related to use and fourteen views about AD rated by GPs using a 5-item Likert scale.
Eleven hundred and seven doctors completed the surveys (18.2%), of whom 92.5% (95% confidence interval [CI] 90.8-94%) reported having used the AD strategy in their practice at least once. GPs felt very confident in using a deprescribing strategy in patients with common cold and influenza (97.6% and 93.5%, respectively) but less with acute bronchitis (45.5%); 12.1% (95% CI, 10.2-14.2%) considered this practice harmful to patients. Respondents reported using AD more frequently when they initiated the antibiotic course (96.8%; 95% CI, 95.5-97.7) than when the treatment was initiated by another doctor (52.3%; 95% CI, 49.3-55.3%). However, doctors aged >60 years were more prone to use AD compared with younger colleagues (64.5% vs. 50%; < 0.005).
The GPs in this study employ the strategy of AD. Nonetheless, essential differences lie in their views of the way the strategy is used. Further studies are warranted to explore the beliefs behind these perceptions and promote wider use of AD by GPs.
如果进一步治疗弊大于利，医生可能会建议患者在预定疗程结束前停止使用抗生素。
本研究探讨全科医生（GP）对抗生素减量（AD）在全科实践中应用的看法。
这是一项在 2022 年 2 月至 3 月间进行的横断面、问卷调查研究。邀请隶属于西班牙最大的初级保健科学协会的全科医生参与。调查包括与使用 AD 相关的两个陈述和 14 个关于 AD 的观点，GP 用 5 项李克特量表对其进行评分。
1107 名医生完成了调查（18.2%），其中 92.5%（95%置信区间 [CI] 90.8-94%）报告在实践中至少使用过一次 AD 策略。GP 对在普通感冒和流感患者中使用减量策略非常有信心（分别为 97.6%和 93.5%），但在急性支气管炎患者中信心较低（45.5%）；12.1%（95% CI，10.2-14.2%）认为这种做法对患者有害。当他们启动抗生素疗程时（96.8%；95% CI，95.5-97.7），受访者报告比当治疗由另一位医生启动时（52.3%；95% CI，49.3-55.3%）更频繁地使用 AD。然而，年龄 >60 岁的医生比年轻同事更倾向于使用 AD（64.5%比 50%；<0.005）。
本研究中的全科医生采用 AD 策略。然而，他们在使用该策略的方式上存在显著差异。需要进一步的研究来探索这些观念背后的信念，并促进全科医生更广泛地使用 AD。
