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抗生素治疗的背后因素:伦巴第初级保健儿科医生调查。

Factors behind Antibiotic Therapy: A Survey of Primary Care Pediatricians in Lombardy.

机构信息

Department of Pathophysiology and Transplantation, University of Milan, 20122 Milan, Italy.

Department of Clinical Sciences and Community Health, University of Milan, 20122 Milan, Italy.

出版信息

Int J Environ Res Public Health. 2024 Aug 18;21(8):1091. doi: 10.3390/ijerph21081091.

Abstract

BACKGROUND

Antimicrobial resistance represents one of the most significant future health challenges in terms of both clinical and economic impacts on healthcare systems. The reason behind this issue is the misuse of antibiotics for the treatment of non-bacterial pathologies. The objective of this study is to investigate the factors underlying antibiotic prescription in pediatricians in the Lombardy region.

METHODS

The study was conducted by means of a 32-item questionnaire that investigated both pediatricians' knowledge of antimicrobial resistance and the factors determining the choice to prescribe antibiotic therapy.

RESULTS

A total of 253 pediatricians participated in the survey. Most participants (71.6%) reported as highly relevant the need for a national plan against AMR. However, approximately half of the respondents declared the phenomenon of AMR as uncommon in pediatric settings. Among the identified associated factors, diagnostic uncertainty was associated with a stronger fear of legal repercussions and the influence of parental pressure when prescribing antibiotics.

CONCLUSIONS

The inability to diagnose the bacterial origin of an infection might be the primary driver of prescribing choices, rather than other non-clinical factors, such as parental demands or a fear of lawsuits.

摘要

背景

抗菌药物耐药性是未来对医疗保健系统产生重大临床和经济影响的最严峻挑战之一。造成这一问题的原因是抗生素被滥用于治疗非细菌性疾病。本研究旨在探究伦巴第地区儿科医生开具抗生素处方的背后因素。

方法

本研究采用了一份 32 项问题的调查问卷,调查了儿科医生对抗菌药物耐药性的认知,以及决定选择开具抗生素治疗的因素。

结果

共有 253 名儿科医生参与了这项调查。大多数参与者(71.6%)认为制定国家抗菌药物耐药性行动计划非常重要。然而,大约一半的受访者表示,儿科环境中抗菌药物耐药性现象并不常见。在所确定的相关因素中,诊断不确定性与更强烈的法律后果恐惧以及在开具抗生素时受到父母压力的影响有关。

结论

无法诊断感染的细菌来源可能是开具处方选择的主要驱动因素,而不是其他非临床因素,如父母的要求或对诉讼的恐惧。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/b1ce/11354739/43d7f194bb7a/ijerph-21-01091-g001.jpg

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