BackgroundThis study investigates the barriers and facilitators of the use of antibiotics in acute respiratory tract infections by general practitioners (GPs) in Germany.MethodsA multidisciplinary team designed and pre-tested a written questionnaire addressing the topics awareness of antimicrobial resistance (7 items), use of antibiotics (9 items), guidelines/sources of information (9 items) and sociodemographic factors (7 items), using a five-point-Likert-scale (“never” to “very often”). The questionnaire was mailed by postally to 987 GPs with registered practices in eastern Germany in May 2015.Results34% (340/987) of the GPs responded to this survey. Most of the participants assumed a multifactorial origin for the rise of multidrug resistant organisms. In addition, 70.2% (239/340) believed that their own prescribing behavior influenced the drug-resistance situation in their area. GPs with longer work experience (> 25 years) assumed less individual influence on drug resistance than their colleagues with less than 7 years experience as practicing physicians (Odds Ratio [OR] 0.32, 95% Confidence Interval [CI] 0.17–0.62; P < 0.001). 99.1% (337/340) of participants were familiar with the “delayed prescription” strategy to reduce antibiotic prescriptions. However, only 29.4% (74/340) answered that they apply it “often” or “very often”. GPs working in rural areas were less likely than those working in urban areas to apply delayed prescription.ConclusionThe knowledge on factors causing antimicrobial resistance in bacteria is good among GPs in eastern Germany. However measures to improve rational prescription are not widely implemented yet. Further efforts have to be made in order to improve rational prescription of antibiotic among GPs. Nevertheless, there is a strong awareness of antimicrobial resistance among the participating GPs.Electronic supplementary materialThe online version of this article (10.1186/s12879-018-3120-y) contains supplementary material, which is available to authorized users.

This study reveals considerable differences in perceptions and attitudes to ABR among the groups investigated. The results can help to tailor future interventions. Furthermore, they promote mutual understanding and thus support the One Health approach.

Zusammenfassung Ziel der Studie Untersuchung der Einflussfaktoren auf die psychische und körperliche Lebensqualität bei älteren, multimorbiden Patientinnen und Patienten ab 50 Jahren in Hausarztpraxen. Methodik 219 Patienten mit multiplen chronischen Erkrankungen wurden zu Lebensqualität, Bindung, Depression und dem Gesundheitszustand zu Baseline und Follow-up nach 12 Monaten untersucht. Multivariate Analysen wurden durchgeführt, um potenzielle Prädiktoren zu identifizieren. Ergebnisse Depression, Alter und die bindungsbezogene Vermeidung hatten einen negativen, der Gesundheitszustand einen positiven Einfluss auf die körperbezogene Lebensqualität. Die psychische Lebensqualität wurde negativ durch die bindungsbezogene Angst und Depression beeinflusst. Relevante Prädiktoren, welche die Lebensqualität in einem Jahr vorhersagen konnten, waren der Gesundheitszustand, Depression und Bindungsangst. Schlussfolgerung Zur Erhaltung der Lebensqualität sollten bei multimorbiden Patienten die mentale Gesundheit und die Bindungsbedürfnisse der Patienten berücksichtigt werden.