Factors Influencing Antibiotic Prescribing and Antibiotic Resistance Awareness Among Primary Care Physicians in Poland.

Abstract

Introduction: Antibiotic resistance is a major public health problem in Europe. Most antibiotics are sold only by prescription in Poland, and it is mainly up to physicians to decide whether to start antibiotic treatment. Therefore, we analyzed the factors influencing the prescribing of antibiotics for upper respiratory tract infections by primary care physicians in Poland, attitudes toward antibiotic resistance, and knowledge of the principles of antibiotic use. Methods: We conducted a CAWI (Computer-Assisted Web Interview) survey, carried out using a proprietary survey distributed online. Results: A total of 528 doctors participated in the study. The result of the physical examination and additional tests, as well as the recommendations of scientific societies are the most important in deciding whether to start antibiotic therapy. Patient pressure (p < 0.011) and workload (p = 0.021) significantly influenced the decision to prescribe an antibiotic among primary care physicians and physicians in the course of specialization, who fear of legal consequences (p < 0.001). The habits of other physicians (p < 0.001) working at the same facility appeared to be additionally important. Conclusions: The decision to implement antibiotic therapy in upper respiratory tract infections is influenced by several factors that depend on the doctor (including place of work and seniority) and the patient (clinical symptoms, expectation of antibiotic prescription). The physician's level of knowledge contributes to reducing antibiotic prescribing. Considering the factors associated with the level of knowledge and awareness, together with a high prevalence of self-medication with antibiotics in Polish population, there is a strong need to design educational interventions aimed at reducing inappropriate antibiotic prescribing and preventing antibiotic resistance in Poland.