Komiya Kosaku, Kudoh Ryohei, Kaku Norihito, Shindo Yuichiro, Hayashi Tatsuya, Kasahara Kei, Oishi Tomohiro, Ishiwada Naruhiko, Ito Makoto, Yotsuyanagi Hiroshi, Hasegawa Naoki, Tateda Kazuhiro, Hotomi Muneki, Yanagihara Katsunori
Respiratory Medicine and Infectious Diseases, Oita University Faculty of Medicine, 1-1 Idaigaoka, Hasama-machi, Yufu, Oita 879-5593, Japan.
Department of Laboratory Medicine, Nagasaki University Hospital, 1-7-1 Sakamoto, Nagasaki 852-8501, Japan.
Antibiotics (Basel). 2024 Aug 1;13(8):724. doi: 10.3390/antibiotics13080724.
Although antibiotics are most frequently prescribed for respiratory tract infections, effective interventions for their proper use by physicians have not been fully established. We assessed the impact of educational films on the rates of antibiotic prescriptions for respiratory tract infections using fictitious scenarios. In this nationwide web-based survey prospective study, a total of 1100 physicians were included. The physicians were required to view educational short films and determine the need for prescribing antibiotics in 10 fictitious scenarios involving adults diagnosed with different acute respiratory tract infectious diseases. The antibiotic prescription rates for each scenario were compared before and after viewing the educational short film. The rates of antibiotic prescription significantly decreased after viewing the educational film, especially in cases with a narrowly defined common cold (from 51% to 15%), mild pharyngolaryngitis (from 71% to 25%), and acute bronchitis without chronic respiratory underlying diseases (from 63% to 23%). Alternatively, a slight decrease in rates was observed in cases with moderate or severe rhinosinusitis (from 94% to 79%), moderate or severe acute pharyngitis (from 88% to 69%), and acute bronchitis with chronic lung disease (from 70% to 58%), for which antibiotics are recommended. Educational short films may encourage the proper use of antibiotics for respiratory tract infections; however, the possibility of undertreatment in patients requiring antibiotics must be considered.
尽管抗生素最常用于治疗呼吸道感染，但尚未完全确立让医生正确使用抗生素的有效干预措施。我们使用虚拟场景评估了教育影片对呼吸道感染抗生素处方率的影响。在这项全国性的基于网络的调查前瞻性研究中，共纳入了1100名医生。要求医生观看教育短片，并在10个涉及被诊断患有不同急性呼吸道传染病的成年人的虚拟场景中确定是否需要开具抗生素。比较了观看教育短片前后每个场景的抗生素处方率。观看教育短片后，抗生素处方率显著下降，尤其是在明确诊断为普通感冒（从51%降至15%）、轻度咽喉炎症（从71%降至25%）以及无慢性呼吸道基础疾病的急性支气管炎（从63%降至23%）的病例中。相反，在推荐使用抗生素的中度或重度鼻-鼻窦炎（从94%降至79%）、中度或重度急性咽炎（从88%降至69%）以及患有慢性肺病的急性支气管炎（从70%降至58%）的病例中，观察到处方率略有下降。教育短片可能会促使医生正确使用抗生素治疗呼吸道感染；然而，必须考虑到在需要使用抗生素的患者中存在治疗不足的可能性。
