ArticleBMC family practice2016
Combined assessment of clinical and patient factors on doctors' decisions to prescribe antibiotics.
Article in BMC family practice, 2016. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 13 papers, 1 of them a synthesis that pooled it.
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Who cites it
13 citing papers in PubMed, 1 synthesis or guideline pooled it, 23 citations in OpenAlex.
- Antibiotic prescribing for acute respiratory tract infections in primary care: an updated and expanded meta-ethnography.The British journal of general practice : the journal of the Royal College of General Practitioners · 2018Pooled it
- Nurse Decision-making for Suspected Urinary Tract Infections in Nursing Homes: Potential Targets to Reduce Antibiotic Overuse.Journal of the American Medical Directors Association · 2021Trial
- Use of a Smartphone Medication Reminder Application to Support Emerging Adult Adherence to Non-Antibiotic Treatment for Viral Upper Respiratory Tract Infection.Journal of primary care & community healthTrial
- Between Patient Pressure and Professional Responsibility: Antibiotic Prescribing Practices in Primary Care.Healthcare (Basel, Switzerland) · 2026Article
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- A scoping review and behavioural analysis of factors underlying overuse of antimicrobials.JAC-antimicrobial resistance · 2023Article
- Determinants of clinician and patient to prescription of antimicrobials: Case of Mulanje, Southern Malawi.PLOS global public health · 2022Article
- Context and general practitioner decision-making - a scoping review of contextual influence on antibiotic prescribing.BMC family practice · 2021Article
- Perspectives of pharmaceutical stakeholders on determinants of medicines accessibility at the primary care level.The Journal of the Egyptian Public Health Association · 2021Article
- Parental self-medication with antibiotics for children promotes antibiotic over-prescribing in clinical settings in China.Antimicrobial resistance and infection control · 2020Article
- Prevalence and clinical associations of wheezes and crackles in the general population: the Tromsø study.BMC pulmonary medicine · 2019Article
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Corrections and comments
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Authors and funding
6 authors at 1 institution in 1 country.
Funding
No grant is acknowledged in the PubMed record.
Abstract
backgroundAntibiotic overprescription is a worldwide problem. Decisions regarding antibiotic prescription for respiratory tract infections (RTIs) are influenced by medical and non-medical factors.
methodsIn family medicine practices in Białystok, Poland, family medicine residents directly observed consultations with patients with RTI symptoms. The observing residents completed a questionnaire including patient data, clinical symptoms, diagnosis, any prescribed antibiotic, and assessment of ten patient pressure factors.
resultsOf 1546 consultations of patients with RTIs, 54.26 % resulted in antibiotic prescription. Antibiotic prescription was strongly associated with rales (OR 26.90, 95 % CI 9.00-80.40), tonsillar exudates (OR 13.03, 95 % CI 7.10-23.80), and wheezing (OR 14.72, 95 % CI 7.70-28.10). The likelihood of antibiotic prescription was increased by a >7-day disease duration (OR 3.94, 95 % CI 2.80-5.50), purulent nasal discharge (OR 3.87, 95 % CI 2.40-6.10), starting self-medication with antibiotics (OR 4.11, 95 % CI 2.30-7.30), and direct request for antibiotics (OR 1.87, 95 % CI 1.30-2.80). Direct request not to prescribe antibiotics decreased the likelihood of receiving antibiotics (OR 0.34, 95 % CI 0.27-0.55).
conclusionWhile clinical signs and symptoms principally impact prescribing decisions, patient factors also contribute. The most influential patient pressure factors were starting self-medication with antibiotics, and directly requesting antibiotic prescription or no antibiotic prescription. Interventions aiming to improve clinical sign and symptom interpretation and to help doctors resist direct patient pressure could be beneficial for reducing unnecessary antibiotic prescribing.
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