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法国奥克西塔尼地区普通医疗实践中社区获得性感染推荐抗生素治疗知识的横断面研究。

Knowledge of recommended antibiotic treatments for community-acquired infections in general medical practice: a cross-sectional study in Occitanie region, France.

机构信息

Internal Medicine Unit, Groupe Hospitalier Sud Ile de France, Melun, France.

Infectious Diseases Unit, Groupe Hospitalier Sud Ile de France, Melun, France.

出版信息

Sci Rep. 2023 Oct 12;13(1):17312. doi: 10.1038/s41598-023-43809-0.

Abstract

To assess and analyse the knowledge of recommended antibiotic treatments, focusing on the appropriate drugs and treatment durations for the most common community-acquired infections in general medical practice in Occitanie region, France. A web-based survey was conducted over a 3-month period, from October, 2018 to January, 2019. All participants answered directly through the online platform. For the analysis of overtreatment risk, a score based system was adopted and two scores were produced: the duration score and the treatment score. 413 general practitioners completed the survey. The overall rate of concordance with guidelines in terms of both drug choice and treatment length was 2974/4956 (60%) answers. Diseases with at least 70% good answers included cystitis, group A streptococcal pharyngitis, and bacterial superficial skin infections. Diseases with fewer than 50% good answers included pyelonephritis, dog bite wounds, and community-acquired pneumonia in patients aged ≥ 65 years. Factors associated with the risk of overtreatment were age > 40 years, country setting and hospital employment. Knowledge of treatment durations is satisfactory with 60% of recommendations being met. However, varying levels were observed according to different diseases. This study highlighted a very high rate of adherence when recommendations were clear. In contrast, low levels of adherence were observed when recommendations were ambiguous or when conflicting guidelines existed.

摘要

评估和分析推荐抗生素治疗方案的知识,重点是法国奥克西塔尼地区普通医疗实践中最常见的社区获得性感染的适当药物和治疗持续时间。在 2018 年 10 月至 2019 年 1 月的 3 个月期间进行了一项基于网络的调查。所有参与者都通过在线平台直接回答。为了分析过度治疗的风险,采用了基于评分的系统,并产生了两个评分:持续时间评分和治疗评分。413 名全科医生完成了调查。在药物选择和治疗时间方面,与指南一致的总体比例为 4956 个回答中的 2974 个(60%)。至少有 70%的回答正确的疾病包括膀胱炎、A 组链球菌性咽炎和细菌性浅层皮肤感染。少于 50%的回答正确的疾病包括肾盂肾炎、狗咬伤和 65 岁以上患者的社区获得性肺炎。与过度治疗风险相关的因素包括年龄>40 岁、国家背景和医院就业。有 60%的治疗持续时间建议得到满足,这表明对治疗的了解是令人满意的。然而,根据不同的疾病,观察到的水平存在差异。这项研究突出表明,当建议明确时,遵循建议的比例非常高。相比之下,当建议不明确或存在相互冲突的指南时,遵循建议的比例较低。

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