Alharbi Ahlam S, Alharbi Mayar S, Almutairi Kholoud B, Alsaady Raghad M, Alsaedi Rouz M, Alhejaili Renad S
Family and Community Medicine, Ministry of Health (MOH), Riyadh, SAU.
Medicine and Surgery, Al-Rayan Colleges, Al Medinah, SAU.
Cureus. 2024 Jan 31;16(1):e53298. doi: 10.7759/cureus.53298. eCollection 2024 Jan.
Unnecessary prescription of antibiotics for patients with upper respiratory tract infections (URTIs) carries the potential risk to the development of bacterial resistance.
This study aimed to investigate the behavior of primary healthcare (PHC) physicians toward an antibiotic prescription for URTI, Al-Madinah City, Saudi Arabia in 2021.
A cross-sectional study was conducted at PHC centers in Al-Madinah City, Saudi Arabia. The study invited all physicians in the randomly selected 28 PHC centers to participate in the study. A master sheet adopted from a researcher done in the Asir region of Saudi Arabia about the pattern of prescription for URTI was used and included data about socio-demographic characteristics and data about presenting symptoms and signs of URTIs, the clinical diagnosis, type of medication prescribed, and duration of treatment also, included data about the factors that press physicians to prescribe antibiotics and their response. The questionnaire was filled out and returned back by 140 physicians. The collected data were analyzed and tabulated using appropriate statistical tests.
The mean age of the studied physicians was 34.4 ± 7.6 years (25-59 years). General practitioners and specialists were 66.4% and 33.6%, respectively. The prevalence of antibiotic prescriptions was 44.3%. The most prescribed antibiotics were amoxicillin (58.6%) and Augmentin (28.6%). Congested tonsils (87.1%), ear discharge (84.2%), and cervical lymphadenopathy (89.3%) were the most clinical factors that affected physicians' decisions to prescribe antibiotics for URTI. The non-clinical factors affecting physicians' decisions include patient request (52.8%) and press (28.5%), with no statistically significant difference detected between general practitioners and specialists.
The study findings indicate the need to develop intervention programs targeting physicians as well as the general population to decrease inappropriate antibiotic prescriptions in primary care centers.
对上呼吸道感染（URTI）患者不必要地开具抗生素处方存在导致细菌耐药性发展的潜在风险。
本研究旨在调查2021年沙特阿拉伯麦地那市基层医疗（PHC）医生针对URTI开具抗生素处方的行为。
在沙特阿拉伯麦地那市的基层医疗中心进行了一项横断面研究。该研究邀请了随机选择的28个基层医疗中心的所有医生参与研究。采用了沙特阿拉伯阿西尔地区一名研究人员所做的关于URTI处方模式的主表，其中包括社会人口学特征数据以及URTI的症状和体征、临床诊断、所开药物类型和治疗持续时间的数据，还包括促使医生开具抗生素的因素及其反应的数据。140名医生填写并返还了问卷。使用适当的统计测试对收集到的数据进行分析并制成表格。
所研究医生的平均年龄为34.4±7.6岁（25 - 59岁）。全科医生和专科医生分别占66.4%和33.6%。抗生素处方的患病率为44.3%。最常开具的抗生素是阿莫西林（58.6%）和阿莫西林克拉维酸钾（28.6%）。扁桃体充血（87.1%）、耳溢液（84.2%）和颈部淋巴结病（89.3%）是影响医生为URTI开具抗生素决定的最主要临床因素。影响医生决定的非临床因素包括患者要求（52.8%）和压力（28.5%），全科医生和专科医生之间未检测到统计学上的显著差异。
研究结果表明需要制定针对医生以及普通人群的干预计划，以减少基层医疗中心不适当的抗生素处方。
