Evidence map›Paper›PMID 41772432›Full record

ArticleBMC primary care2026

Contexts and concepts influencing general practitioners' and patients' decision-making on antibiotic prescriptions for upper respiratory tract infections in the Northern Dutch-German cross-border region - a qualitative study.

Vaitiare Mulderij-Jansen, Aida Bedri, Till Herdeg, Mieke Andre, Luuk Holterman, Marit Boer, Michael H Freitag, Adriana Tami, Nienke Beerlage-de Jong

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Article in BMC primary care, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 1 paper.

0numbers the graph read from it
0cells of the map it votes in
1citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

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The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

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Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

1 citing paper in PubMed.

  1. Article
4 · The record

Corrections and comments

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5 · Who and what money

Authors and funding

9 authors.

Vaitiare Mulderij-JansenDepartment of Medical Microbiology and Infection Prevention, University of Groningen, University Medical Center Groningen, Groningen, The Netherlands. v.i.c.jansen@umcg.nl.
Aida BedriDepartment of Health Services Research, Division of General Practice, Carl von Ossietzky Universität Oldenburg, Faculty VI Medicine and Health Sciences, Oldenburg, Germany.
Till HerdegDepartment of Health Services Research, Division of General Practice, Carl von Ossietzky Universität Oldenburg, Faculty VI Medicine and Health Sciences, Oldenburg, Germany.
Mieke AndreDepartment of Medical Microbiology and Infection Prevention, University of Groningen, University Medical Center Groningen, Groningen, The Netherlands.
Luuk HoltermanDepartment of Medical Microbiology and Infection Prevention, University of Groningen, University Medical Center Groningen, Groningen, The Netherlands.
Marit BoerDepartment of Medical Microbiology and Infection Prevention, University of Groningen, University Medical Center Groningen, Groningen, The Netherlands.
Michael H FreitagDepartment of Health Services Research, Division of General Practice, Carl von Ossietzky Universität Oldenburg, Faculty VI Medicine and Health Sciences, Oldenburg, Germany.
Adriana TamiDepartment of Medical Microbiology and Infection Prevention, University of Groningen, University Medical Center Groningen, Groningen, The Netherlands.
Nienke Beerlage-de JongDepartment of Medical Microbiology and Infection Prevention, University of Groningen, University Medical Center Groningen, Groningen, The Netherlands.

Funding

Ministry for Science and Culture of Lower Saxony (MWK) ZN3730
6 · The paper itself

Abstract

backgroundRedundant antibiotic prescribing in primary care is a key driver of antimicrobial resistance. In the northern Dutch-German border region (Ems-Dollart region), antibiotic prescription rates increase as one approaches the border, and the reasons for this trend still need to be fully understood. The first step to address inappropriate antibiotic prescribing is to understand the aspects influencing the decision-making of those involved, especially for common conditions like upper respiratory tract infections (URTIs) that are often associated with redundant antibiotic use. Therefore, we examined and compared the concepts and contexts influencing the decision-making of Dutch and German general practitioners (GPs) and patients in the Ems-Dollart region concerning antibiotic prescription for URTIs.

methodsFrom December 2023 to mid-April 2024, GPs (n = 20) and patients (n = 21) were interviewed. The interviews were recorded, transcribed, translated into English, and coded using MAXQDA 24.2.0 software. Two deductive and inductive coding cycles using primary- and sub-codes were applied. The coded data was analyzed using thematic discourse analysis methodology.

resultsWhile there were reported differences in guideline adherence, this study found that German and Dutch GPs employ quite similar approaches when diagnosing and treating URTIs. Antibiotic prescription was based on consistent aspects, including diagnostic results (such as elevated C-reactive protein levels), the severity of symptoms (including fever and prolonged duration), time constraints, and perceived patient pressure. Additionally, patient age (young children and older adults) and the presence of comorbidities were key considerations in antibiotic prescription for URTIs. Moreover, there are prevalent misconceptions among patients regarding the etiology of URTIs and the appropriate use of antibiotics. Some patients believe that bacteria primarily cause the common flu or think antibiotics are necessary to treat viral infections.

conclusionsThis study explores GPs’ and patients’ perspectives on URTI treatment, including their management preferences and the utilization of home remedies and over-the-counter medications. In addition, it highlights the wide-ranging non-medical aspects influencing GPs’ decisions, underscoring their critical role in antimicrobial resistance stewardship initiatives. Furthermore, the study identifies patient misconceptions regarding URTIs, which may lead to inappropriate antibiotic requests. Addressing these aspects is essential for optimizing URTI management and promoting prudent antibiotic prescribing.

Indexed as

Anti-Bacterial AgentsDecision MakingGeneral PractitionersInappropriate PrescribingPractice Patterns, Physicians'Respiratory Tract InfectionsAdolescentAdultAgedFemaleGermanyGuideline AdherenceHumansMaleMiddle AgedNetherlandsAnti-Bacterial AgentsAntibioticsAntimicrobialHealth BehaviorInfectionsPrimary CarePublic HealthResistanceUpper Respiratory Tract

Identifiers

PMID41772432
PMCPMC13063523

What OpenQuestion holds

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LicenceCC BY-NC-ND
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Registered trials

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.