Unterschiede im Verschreibungsverhalten von Antibiotika bei Allgemein- und Kinderärzten in Hessen

Abbas, Sascha; Ihle, Peter; Heymans, L; Küpper-Nybelen, J.; Schubert, Ingrid

doi:10.1055/s-0030-1263321

Cited by 15 publications

(7 citation statements)

References 2 publications

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“…Of these, 25 studies did not fulfil the eligibility criteria, for the following reasons: no data on children ( n = 7 studies), other country than in this study ( n = 12), no data on diagnoses of this study ( n = 4), no data on antibiotic prescription rates ( n = 2). Eleven studies [ 2 , 7 , 8 , 75 – 82 ] with a total of 16 diagnosis groups (cough/tracheitis/bronchitis: n = 2, sore throat/pharyngitis: n = 2, ear pain/otitis: n = 6, Upper RTI/RTI: n = 6) were eligible for comparisons (further data in Table 5 ). All 16 comparison groups had higher antibiotic prescription rates than the corresponding C-, and A-groups of this study ( Figure 1 ).…”

Section: Resultsmentioning

confidence: 99%

“…Antibiotic prescription rates ranged from 31.0% (nonspecific RTI [ 7 ]) to 84.1% (OM [ 77 ]). Compared to the rates in the A-groups, prescription rates in the comparison groups were 6.7 [ 80 ] to 13.3 [ 77 ] times higher for cough/bronchitis, 26.2 [ 77 ] to 29.2 [ 81 ] times higher for sore throat/pharyngitis, 6.1 [ 75 ] to 12.2 [ 77 , 79 ] times higher for ear pain/OM, and 6.9 [ 7 ] to 15.1 [ 78 ] times higher for upper RTI/RTI.…”

Section: Resultsmentioning

confidence: 99%

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Antibiotic Use in Children with Acute Respiratory or Ear Infections: Prospective Observational Comparison of Anthroposophic and Conventional Treatment under Routine Primary Care Conditions

Hamre

Glockmann

Schwarz³

et al. 2014

Evidence-Based Complementary and Alternative Medicine

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Children with acute respiratory or ear infections (RTI/OM) are often unnecessarily prescribed antibiotics. Antibiotic resistance is a major public health problem and antibiotic prescription for RTI/OM should be reduced. Anthroposophic treatment of RTI/OM includes anthroposophic medications, nonmedication therapy and if necessary also antibiotics. This secondary analysis from an observational study comprised 529 children <18 years from Europe (AT, DE, NL, and UK) or USA, whose caregivers had chosen to consult physicians offering anthroposophic (A-) or conventional (C-) treatment for RTI/OM. During the 28-day follow-up antibiotics were prescribed to 5.5% of A-patients and 25.6% of C-patients (P < 0.001); unadjusted odds ratio for nonprescription in A- versus C-patients 6.58 (95%-CI 3.45–12.56); after adjustment for demographics and morbidity 6.33 (3.17–12.64). Antibiotic prescription rates in recent observational studies with similar patients in similar settings, ranged from 31.0% to 84.1%. Compared to C-patients, A-patients also had much lower use of analgesics, somewhat quicker symptom resolution, and higher caregiver satisfaction. Adverse drug reactions were infrequent (2.3% in both groups) and not serious. Limitation was that results apply to children of caregivers who consult A-physicians. One cannot infer to what extent antibiotics might be avoided in children who usually receive C-treatment, if they were offered A-treatment.

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Section: Resultsmentioning

confidence: 99%

Section: Resultsmentioning

confidence: 99%

Antibiotic Use in Children with Acute Respiratory or Ear Infections: Prospective Observational Comparison of Anthroposophic and Conventional Treatment under Routine Primary Care Conditions

Hamre

Glockmann

Schwarz³

et al. 2014

Evidence-Based Complementary and Alternative Medicine

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“…Gender differences concerning antibiotic use are already known: Data from the National Ambulatory Medical Care Survey from 1992 in the USA indicate a significant positive association between antibiotic consumption and female sex [29]. Moreover, findings from Abbas et al suggest higher antibiotic use for girls compared to boys in all age groups except for 2-4-years old children [30]. Our results regarding regional differences are in line with the results of the EVA survey ( E inflüsse auf die ärztliche V erschreibung von A ntibiotika in Deutschland) which investigates influences on prescribing patterns by physicians in Germany.…”

Section: Discussionmentioning

confidence: 99%

Pharmacoepidemiology of common colds and upper respiratory tract infections in children and adolescents in Germany

Eckel

Sarganas

Wolf

et al. 2014

BMC Pharmacol Toxicol

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BackgroundMedicines to treat common colds (CC) and upper respiratory tract infections (URTI) are widely used among children, but there are only few data about treatments actually applied for these diseases. In the present study we analyze the prevalence and correlations of self-medicated and prescribed drug use for the treatment of CCs and URTIs among children and adolescents in Germany.MethodsMedicine use during the week preceding the interview was recorded among 17,450 children (0–17 years) who participated in the drug interview of the 2003–2006 German Health Interview and Examination Survey for Children and Adolescents (KiGGS). The definition of CCs and URTIs in the present study included the WHO-ICD-10 codes J00, J01.0, J01.9, J02.0, J02.9, J03.0, J03.9, J04.0, J06.8, J06.9, J11.1, J11.8, R05 and R07.0. Using the complex sample method, the prevalence and associated socio-demographic factors of self-medication, prescribed medicines and antibiotics were defined.Results13.8% of the participating girls and boys use drugs to treat a CC or an URTI. About 50% of this group use prescribed medications. Among the users of prescribed medication, 11.5% use antibiotics for the treatment of these diseases. Looking at all prescribed medicines we find associations with younger age, immigration background, and lower social status. Antibiotic use in particular is associated with female sex, higher age, residency in the former East Germany and immigration background.ConclusionsThe use of medicines to treat CCs or URTIs is widespread among children and adolescents in Germany. Thus, longitudinal studies should investigate the risks associated with this drug use. Differences in socio-demographic variables regarding exposure to antibiotic use indicate that there could be an implausible prescribing behavior among physicians in Germany.

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“…In addition, the study found that pressure exerted to obtain antibiotics is often overestimated [16]. This is confirmed by other studies, which showed that the interpretation of patient expectations is difficult and leaves room for uncertainty [17,18]. A Cochrane Review examined 10 studies on shared decision making (SDM) in antibiotic prescriptions for acute respiratory infections and found that it reduced the prescription of antibiotics by 40 % [19].…”

Section: Introductionmentioning

confidence: 70%

Dealing with patient expectations regarding the prescription of antibiotics in ambulatory care in Germany: A qualitative analysis

Stuermlinger

Poß-Doering

Glassen

et al. 2019

Preprint

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Background Antibiotics prescription rates are relatively high in primary care in Germany. Patients’ expectations have frequently been mentioned as reason for high prescription rates. The extent to which patients’ expectations play a role and the strategies that physicians use to deal with these expectations and prevent non-indicated prescriptions in acute, uncomplicated infections are the subject of this paper.Methods In this qualitative study, twenty-seven semi-structured interviews with physicians were conducted in 2018. Data were audiotaped, pseudonymized and transcribed verbatim. The analysis was based on a framework analysis according to the Tailored Implementation in Chronic Diseases (TICD) checklist, and was expanded for deeper analysis and completed with the Behavior Change Techniques (BCT) taxonomy. Results The data revealed that patients’ expectations regarding the prescription of antibiotics can play an important role, although they may be ignored by physicians. If physicians respond to patients’ expectations, they use various strategies to deal and communicate with patients. Successful communication is more often achieved, if the physician takes sufficient time with the patient and if this results in a cooperative conversation. Thus, patients get informed about antibiotics and antimicrobial resistance, and it is possible to discuss alternative treatments. Seven strategies from the BCT taxonomy were mentioned by physicians in this study.Conclusion Constructive physician-patient communication was key to reducing antibiotic prescribing. The range of behavior change techniques mentioned by physicians was relatively limited and the use of a wider range of strategies could be the focus of future implementation strategies. Trial registration: ISRCTN, ISRCTN58150046. Registered 24 August 2017. Keywords Antibiotics prescription, patient expectations, physician-patient communication, patient education, communication strategies, behavior change technique, qualitative research

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Unterschiede im Verschreibungsverhalten von Antibiotika bei Allgemein- und Kinderärzten in Hessen

Cited by 15 publications

References 2 publications

Antibiotic Use in Children with Acute Respiratory or Ear Infections: Prospective Observational Comparison of Anthroposophic and Conventional Treatment under Routine Primary Care Conditions

Antibiotic Use in Children with Acute Respiratory or Ear Infections: Prospective Observational Comparison of Anthroposophic and Conventional Treatment under Routine Primary Care Conditions

Pharmacoepidemiology of common colds and upper respiratory tract infections in children and adolescents in Germany

Dealing with patient expectations regarding the prescription of antibiotics in ambulatory care in Germany: A qualitative analysis

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