Over prescription of antibiotics in children with acute upper respiratory tract infections: A study on the knowledge, attitude and practices of non-specialized physicians in Egypt

Antimicrobial resistance (AMR) is currently one of the global public health threats. Increased antibiotic consumption in humans, animals, and agriculture has contributed directly to the spread of AMR. Upper respiratory tract infections (URIs) are one of the most common conditions treated by antibiot...

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Bibliographic Details
Published in:PloS one 2022-11, Vol.17 (11), p.e0277308-e0277308
Main Authors: Amin, Mariam Taher, Abd El Aty, Mahmoud Attia, Ahmed, Sabra Mohamed, Elsedfy, Ghada Omar, Hassanin, Ebtisam Shawky, El-Gazzar, Amira Fathy
Format: Article
Language:English
Subjects:
Agriculture
Antibiotics
Antimicrobial agents
Antimicrobial resistance
Attitudes
Biology and Life Sciences
Children
Communicable diseases in children
Cross-sectional studies
Drug resistance
Drug therapy
Drugs
Epidemiology
Family physicians
Fever
Global health
Health risks
Infections
Knowledge
Medical errors
Medicine and Health Sciences
Microbiota
Microorganisms
Observational studies
Pediatrics
Penicillin
People and Places
Physicians
Practice
Prescribing
Prescription drugs
Public health
Questionnaires
Rationality
Respiratory tract
Respiratory tract diseases
Respiratory tract infection
Respiratory tract infections
Social Sciences
Surveys
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Summary:Antimicrobial resistance (AMR) is currently one of the global public health threats. Increased antibiotic consumption in humans, animals, and agriculture has contributed directly to the spread of AMR. Upper respiratory tract infections (URIs) are one of the most common conditions treated by antibiotics, even if unnecessary as in cases of viral infections and self-limited conditions which represent the most cases of URIs. Investigating physicians' knowledge, attitudes, and practice regarding antibiotic prescriptions in children with acute URIs may reflect the problem of antibiotic over prescription. This study aims to assess the problem in our community and provide information for further planning of appropriate interventions to optimize antibiotic prescriptions. This is a cross-sectional study for all non-specialized physicians dealing with acute upper respiratory tract infections (URIs) in pediatrics sittings in Assiut district, Egypt. We used a self-administered questionnaire to assess physicians' knowledge, attitudes, and practice. In addition, four clinical vignettes addressing different URI scenarios were included in the questionnaire to assess the patterns of antibiotic prescriptions in common cases. Our study included 153 physicians whose mean age was 32.2 ± 8.7, most of whom were pediatric residents in different health institutes in Assiut district. They had good knowledge as out of the 17 knowledge questions,the mean number of correct answers was 12.4 ± 2.9. Regarding their attitudes, mean attitude scores for inappropriate antibiotic prescribing were low. However, of those scores, the responsibility of others had the highest score (3.8 ± 0.61). Prescribing practice in special conditions of URIs showed that 80% of participants prescribed antibiotics if fever continued for more than five days and 61.4% if the child had a yellowish or greenish nasal discharge. Among 612 clinical vignettes, 326 contained antibiotic prescriptions (53.3%), and appropriate antibiotic prescriptions represented only 8.3% overall. Physicians dealing with acute URIs in outpatients' clinics in the Assiut district have good knowledge about antibiotic use and resistance and demonstrate a good attitude toward appropriate antibiotic use. Although the percentage of inappropriate prescriptions in clinical vignettes in high, more research is required to investigate the factors of antibiotic inappropriate prescribing practice and non-adherence to guidelines. Also, it is essential to
ISSN:1932-6203
1932-6203
DOI:10.1371/journal.pone.0277308