title: Perception of acceptable antibiotic stewardship strategies in outpatient settings.
abstract: BACKGROUND
  Antibiotics are still often inappropriately prescribed in France despite specific measures being taken for over 10years. The 25% decrease in antibiotic prescription advocated in the 2011-2016 National Antibiotic Plan seems difficult to achieve. One of the strategies currently considered in France is the use of a specific prescription form dedicated to antibiotics, with an educational message for patients. We aimed to evaluate the acceptability - by primary care prescribers - of this measure and to evaluate their perception of other antibiotic stewardship strategies.
  
  
  METHODS
  Qualitative study conducted among family physicians, pediatricians, dermatologists, dentists, and ENT specialists using semi-structured interviews. A thematic and framework analysis was then performed.
  
  
  RESULTS
  Thirty prescribing physicians practicing in a specific region of France were included in the study. The dedicated prescription form for antibiotics was deemed excessive and questionable. Other measures, not directly targeting prescribers, were rather well perceived: the unit sales of antibiotics, the restricted reporting of susceptibility tests, or the limitation of the number of molecules available in outpatient settings.
  
  
  CONCLUSIONS
  The results of this exploratory study may guide the national antibiotic stewardship policy in France.
authors.affiliation: Département de médecine générale, université de Lorraine, faculté de médecine, 54000 Nancy, France; École de santé publique, université de Lorraine, faculté de médecine, 54000 Nancy, France; ANTIBIOLOR, CHU de Nancy, réseau Lorrain d'antibiologie, 54000 Nancy, France. Electronic address: vmauffrey@hotmail.fr.
authors.forename: V
authors.initials: V
authors.lastname: Mauffrey
authors.affiliation: École de santé publique, université de Lorraine, faculté de médecine, 54000 Nancy, France; Épidémiologie et évaluation cliniques, CHU de Nancy, pôle QSP2, 54000 Nancy, France; EA4360 APEMAC, université de Lorraine, université Paris Descartes, 54000 Nancy, France.
authors.forename: J
authors.initials: J
authors.lastname: Kivits
authors.affiliation: ANTIBIOLOR, CHU de Nancy, réseau Lorrain d'antibiologie, 54000 Nancy, France; EA4360 APEMAC, université de Lorraine, université Paris Descartes, 54000 Nancy, France; Service de maladies infectieuses et tropicales, CHU de Nancy, 54000 Nancy, France.
authors.forename: C
authors.initials: C
authors.lastname: Pulcini
authors.affiliation: Département de médecine générale, université de Lorraine, faculté de médecine, 54000 Nancy, France; ANTIBIOLOR, CHU de Nancy, réseau Lorrain d'antibiologie, 54000 Nancy, France; CIC-P Inserm, CHU de Nancy, 54000 Nancy, France.
authors.forename: J M
authors.initials: JM
authors.lastname: Boivin
mesh_terms: D000328:Adult; D000368:Aged; D000553:Ambulatory Care / Q000523:psychology / Q000592:standards*; D000900:Anti-Bacterial Agents / Q000627:therapeutic use; D000073602:Antimicrobial Stewardship; D001291:Attitude of Health Personnel; D011307:Drug Prescriptions / Q000706:statistics & numerical data*; D005260:Female; D005602:France; D019983:Guideline Adherence / Q000706:statistics & numerical data; D019538:Health Care Surveys; D006291:Health Policy; D006801:Humans; D057970:Inappropriate Prescribing / Q000523:psychology* / Q000706:statistics & numerical data; D007407:Interviews as Topic; D008297:Male; D008511:Medicine; D008826:Microbial Sensitivity Tests / Q000706:statistics & numerical data; D008875:Middle Aged; D010820:Physicians / Q000523:psychology*; D011320:Primary Health Care / Q000706:statistics & numerical data*; D036301:Qualitative Research; D055815:Young Adult
chemical_list: D000900:Anti-Bacterial Agents
keywords: Antibiorésistance; Antibiotic resistance; Antibiotic stewardship; Bon usage des antibiotiques; Primary care; Soins primaires