Department of Family and Community Medicine, Baylor College of Medicine, Houston, Texas
Center for Innovations in Quality, Effectiveness, and Safety (IQuESt), Michael E. DeBakey Veterans Affairs Medical Center, Houston, Texas.
Ann Fam Med. 2024 Sep-Oct;22(5):421-425. doi: 10.1370/afm.3161.
Patient expectations of receiving antibiotics for common symptoms can trigger unnecessary use. We conducted a survey (n = 564) between January 2020 to June 2021 in public and private primary care clinics in Texas to study the prevalence and predictors of patients' antibiotic expectations for common symptoms/illnesses. We surveyed Black patients (33%) and Hispanic/Latine patients (47%), and over 93% expected to receive an antibiotic for at least 1 of the 5 pre-defined symptoms/illnesses. Public clinic patients were nearly twice as likely to expect antibiotics for sore throat, diarrhea, and cold/flu than private clinic patients. Lack of knowledge of potential risks of antibiotic use was associated with increased antibiotic expectations for diarrhea (odds ratio [OR] = 1.6; 95% CI, 1.1-2.4) and cold/flu symptoms (OR = 2.9; 95% CI, 2.0-4.4). Lower education and inadequate health literacy were predictors of antibiotic expectations for diarrhea. Future antibiotic stewardship interventions should tailor patient education materials to include information on antibiotic risks and guidance on appropriate antibiotic indications.
患者对于常见症状接受抗生素治疗的期望可能会导致不必要的抗生素使用。我们在 2020 年 1 月至 2021 年 6 月期间在德克萨斯州的公立和私立初级保健诊所进行了一项调查（n = 564），以研究患者对于常见症状/疾病接受抗生素治疗的期望的普遍性和预测因素。我们调查了黑人和西班牙裔/拉丁裔患者（分别占 33%和 47%），超过 93%的患者至少期望为 5 种预先定义的症状/疾病中的 1 种开抗生素。与私人诊所患者相比，公共诊所患者对于喉咙痛、腹泻和感冒/流感接受抗生素治疗的期望几乎高出一倍。对于抗生素使用潜在风险的认识不足与对腹泻（比值比 [OR] = 1.6；95%CI，1.1-2.4）和感冒/流感症状（OR = 2.9；95%CI，2.0-4.4）的抗生素期望增加相关。较低的教育程度和较差的健康素养是对腹泻有抗生素期望的预测因素。未来的抗生素管理干预措施应调整患者教育材料，包括有关抗生素风险的信息和有关适当抗生素适应症的指导。
