Syreon Research Institute, Budapest, Hungary.
National Center for Public Health and Pharmacy, Budapest, Hungary.
BMJ Open. 2024 May 10;14(5):e081574. doi: 10.1136/bmjopen-2023-081574.
Inappropriate antibiotic prescribing is a major cause of antimicrobial resistance (AMR). The aim of this study was to explore paediatric general practitioners' (GP Peds) antibiotic prescription practice in suspected respiratory tract infections (RTIs), using the capability-opportunity-motivation-behaviour framework.
The design is a qualitative study based on individual, semistructured telephone or virtual interviews.
Paediatric general practice in Hungary. We applied stratified maximum variation sampling to cover the categories of age, sex and geographical location of participants.
We interviewed 22 GP Peds. Nine were male and 13 were female: 2 of them were less than 40 years old, 14 were between 40 and 60 years, and 6 were above 60 years. 10 worked in low-antibiotic prescription areas, 5 in areas with medium levels of antibiotic prescription, 3 in high-antibiotic prescription areas, and 4 in and around the capital city.
Study participants had varying antibiotic prescription preferences. Personal experience and physical examination play a central role in GP Peds' diagnostic and treatment practice. Participants emphasised the need to treat children in their entirety, taking their personal medical record, social background and sometimes parents' preferences into account, besides the acute clinical manifestation of RTI. Most respondents were confident they apply the most effective therapy even if, in some cases, this meant prescribing medicines with a higher chance of contributing to the development of AMR. Some participants felt antibiotic prescription frequency has decreased in recent years.
Our findings suggest that a more prudent attitude toward antibiotic prescribing may have become more common but also highlight relevant gaps in both physicians' and public knowledge of antibiotics and AMR. To reinforce awareness and close remaining gaps, Hungary should adopt its national AMR National Action Plan and further increase its efforts towards active professional communication and feedback for primary care physicians.
不适当的抗生素处方是导致抗生素耐药性（AMR）的主要原因。本研究旨在使用能力-机会-动机-行为框架探索儿科全科医生（GP Peds）在疑似呼吸道感染（RTIs）中的抗生素处方实践。
这是一项基于个人、半结构化电话或虚拟访谈的定性研究。
匈牙利儿科全科实践。我们采用分层最大变异抽样来涵盖参与者的年龄、性别和地理位置类别。
我们采访了 22 名 GP Peds。其中 9 名是男性，13 名是女性：其中 2 名年龄小于 40 岁，14 名年龄在 40-60 岁之间，6 名年龄在 60 岁以上。10 人在抗生素处方较低的地区工作，5 人在抗生素处方中等水平的地区工作，3 人在抗生素处方较高的地区工作，4 人在首都及其周边地区工作。
研究参与者的抗生素处方偏好各不相同。个人经验和体检在 GP Peds 的诊断和治疗实践中起着核心作用。参与者强调需要全面治疗儿童，考虑他们的个人病历、社会背景，有时还需要考虑到 RTIs 的急性临床表现以及父母的偏好。大多数受访者对他们应用最有效的治疗方法充满信心，即使在某些情况下，这意味着开具有更高机会导致 AMR 发展的药物。一些参与者认为近年来抗生素处方的频率有所下降。
我们的研究结果表明，更谨慎的抗生素处方态度可能变得更为普遍，但也突出了医生和公众对抗生素和 AMR 的认识存在相关差距。为了加强认识和缩小剩余差距，匈牙利应采用其国家 AMR 国家行动计划，并进一步加大努力，为初级保健医生提供积极的专业沟通和反馈。
