Antibiotics for coughing in general practice: a questionnaire study to quantify and condense the reasons for prescribing.
BACKGROUND
Antibiotics are being overprescribed in ambulant care, especially for respiratory tract infections (RTIs). Gaining insight into the actual reasons for prescribing remains important for the design of effective strategies to optimise antibiotic prescribing. We aimed to determine items of importance for the antibiotic prescribing decision and to make them operational for an intervention trial.


METHODS
A postal questionnaire based upon focus group findings was sent to 316 Flemish general practitioners (GPs). On a verbal rating scale the GPs scored to what extent they consider the questionnaire items in decision making in case of suspected RTI in a coughing patient and how strongly the items support or counter antibiotic treatment. Factor analysis was used to condense the data. The relative importance of the yielded operational factors was assessed using Wilcoxon Matched Pairs test.


RESULTS
59.5% completed the study. Response group characteristics (mean age: 42.8 years; 65.9% men) approximated that of all Flemish GPs. Participants considered all the items included in the questionnaire: always the operational factor 'lung auscultation', often 'whether or not there is something unusual happening' - both medical reasons - and to a lesser extent 'non-medical reasons' (P < 0.001). Non-medical as well as medical reasons support antibiotic treatment, but non-medical reasons to a lesser extent (P < 0.001).


CONCLUSIONS
This study quantified, condensed and confirmed the findings of previous focus group research. Practice guidelines and interventions to optimise antibiotic prescribing have to take non-medical reasons into account.
Coenen
Samuel
S
Centre for General Practice, University of Antwerp-UIA, Antwerp, Belgium. samuel.coenen@ua.ac.be
Michiels
Barbara
B
Van Royen
Paul
P
Van der Auwera
Jean-Claude
JC
Denekens
Joke
J
D000328:Adult; D000900:Anti-Bacterial Agents / Q000627:therapeutic use*; D003371:Cough / Q000188:drug therapy* / Q000209:etiology; D011307:Drug Prescriptions; D005163:Factor Analysis, Statistical; D005194:Family Practice; D005260:Female; D006801:Humans; D008297:Male; D010818:Practice Patterns, Physicians'; D012141:Respiratory Tract Infections / Q000150:complications / Q000175:diagnosis / Q000188:drug therapy; D011795:Surveys and Questionnaires
D000900:Anti-Bacterial Agents