ArticleAntimicrobial resistance and infection control2019
Intrinsic and external determinants of antibiotic prescribing: a multi-level path analysis of primary care prescriptions in Hubei, China.
Article in Antimicrobial resistance and infection control, 2019. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 48 papers, 5 of them syntheses that pooled it.
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Who cites it
48 citing papers in PubMed, 5 syntheses or guidelines pooled it.
- A conceptual model of factors potentially influencing prescribing decisions for chronic conditions: an overview of systematic reviews.BMC medicine · 2025Pooled it
- Factors contributing to the variation in antibiotic prescribing among primary health care physicians: a systematic review.BMC primary care · 2024Pooled it
- Prevalence of antibiotics prescription amongst patients with and without COVID-19 in low- and middle-income countries: a systematic review and meta-analysis.Pathogens and global health · 2023Pooled it
- Effectiveness of decision support tools on reducing antibiotic use for respiratory tract infections: a systematic review and meta-analysis.Frontiers in pharmacology · 2023Pooled it
- Antibiotic prescription practices in primary care in low- and middle-income countries: A systematic review and meta-analysis.PLoS medicine · 2020Pooled it
- Determinants of antibiotic prescription pattern and appropriateness in paediatric care in Ghana: a generalized estimating equation approach.BMJ paediatrics open · 2026Article
- Comparison of antibiotic prescription indexes by patient and physician gender and age: a cross-sectional study based on administrative data.BMC primary care · 2026Article
- Artificial intelligence predicts healthcare workers' antibiotic use intentions from psychological and behavioral measures across multiple theories.Scientific reports · 2026Article
- Drivers influencing antibiotics use in pediatric wards across five public hospitals in Zanzibar: a WHO multiple point prevalence survey.Frontiers in antibiotics · 2026Article
- The impact of health and technology shifts on antibiotic use among the elderly in Thailand.Scientific reports · 2025Article
- Antibiotic use at the Centre Hospitalier Universitaire de Zone d'Abomey Calavi/Sô-Ava (CHUZ/AS) in Benin: a point prevalence survey.JAC-antimicrobial resistance · 2025Article
- Assessing the impact of antimicrobial resistance policies on antibiotic use and antimicrobial resistance-associated mortality in children and adults in low and middle-income countries: a global analysis.BMJ public health · 2025Article
- AnalyzingInfection and drug resistance · 2025Article
- Antibiotic Prescribing Decisions for Upper Respiratory Tract Infections Among Primary Healthcare Physicians in China: A Mixed-Methods Approach Based on the Theory of Planned Behavior.Antibiotics (Basel, Switzerland) · 2024Article
- Retracted: Antibiotic Prescribing Behavior of Physicians in Outpatient Departments in Hospitals in Northwest Ethiopia: Structural Equation Modeling Approach.Interactive journal of medical research · 2024Article
- Primary Healthcare Physicians' Insufficient Knowledge Is Associated with Antibiotic Overprescribing for Acute Upper Respiratory Tract Infections in China: A Cross-Sectional Study.Antibiotics (Basel, Switzerland) · 2024Article
- Article
- Exploring factors for antibiotic over-prescription in children with acute upper respiratory tract infections in Assiut, Egypt: a qualitative study.Antimicrobial resistance and infection control · 2024Article
- Qualitative enquiry on factors affecting antibiotic prescribing at primary healthcare facilities in Addis Ababa, Ethiopia.Frontiers in medicine · 2024Article
- Social and cultural determinants of antibiotics prescriptions: analysis from a public community health centre in North India.Frontiers in pharmacology · 2024Article
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Authors and funding
4 authors.
Funding
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Abstract
Background: Irrational use of antibiotics is a major driver of development of antibiotic resistance, which heavily threatens population health worldwide. Understanding the mechanism of physician's antibiotic prescribing decisions is increasingly highlighted to promote prudent use of antibiotics. Therefore, the current study aimed to fill the gap, modelling physician's antibiotic prescribing and identifying the potential intrinsic and external determinants of antibiotic prescribing in primary care. Methods: A total of 428,475 prescriptions from 499 prescribers in 65 primary care facilities in Hubei of China were audited. Teixeira Antibiotic Prescribing Behavioral Model (TAPBM) was referred as theoretical basis to identify intrinsic and external predictors of antibiotic prescriptions. A questionnaire survey was conducted, covering potential physician's intrinsic determinants (knowledge, attitudes and individual characteristics) and external factors both in individual level (patient pressure, time pressure and financial incentives) and institutional level (setting and local socio-economic development). A two-level path analysis was performed linking potential determinants of antibiotic use with physician's actual practices. Results: About 44.28% of the prescriptions contained antibiotics, with 9.28% containing two or more antibiotics. The multi-level path analysis revealed that knowledge was a significant predictor of attitudes (β = 0.154, Conclusion: Antibiotic prescribing practices are complex process and associated with both intrinsic (prescriber) and external (patients and institutional environment) factors. A systematic approach is required to curb over-prescription of antibiotics. Apart from educating prescribers, it is equally important, if not more, to educate patients, break incentives and nurture professional culture within organization to reduce the overuse of antibiotics.
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