Educate to Reduce Unnecessary Antibiotic Prescriptions

TOPLINE: 

Over 90% of patients with symptoms of bronchitis, sinus infections, sore throats, colds or flu, or diarrhea expect antibiotic prescriptions. Visiting a public clinic, lower levels of education, and a lack of knowledge about the risks of taking antibiotics were linked to higher expectations of receiving antibiotics.

METHODOLOGY:

• Researchers conducted a survey of 564 men and women (median age, 49.7 years; 72.2% women) between January 2020 and June 2021 at six public and two private clinics in Texas.
• Among the participants, 33% were Black and 47% were Hispanic or Latine.
• Surveys were conducted in person (n = 197) and by telephone (n = 367).
• The analysis compared patient characteristics and antibiotic expectations between public and private clinics.

TAKEAWAY:

• Over 90% of the study participants expected to receive antibiotics for at least one common symptom; approximately 84% believed that antibiotics would help bronchitis, whereas 72% thought this about sinus infections, 66% about sore throats, 64% about cold/flu, and 36% about diarrhea.
• Patients treated at public clinics were 60% more likely than those attending private clinics to expect antibiotics (P = .016).
• Patients with education levels lower than high school (P = .010) and those without adequate literacy (P = .04) were more likely to expect antibiotics for diarrhea.
• Lack of knowledge about the risks associated with antibiotics was linked to higher expectations of receiving these agents for diarrhea (odds ratio, 1.6; P = .01) and cold or flu symptoms (odds ratio, 2.9; P

IN PRACTICE:

“Future stewardship interventions to reduce inappropriate patient antibiotic expectations should inform patients of the symptoms or illnesses that antibiotics treat and emphasize the individual harms or risks (or harms or risks to others close to an individual) of antibiotics,” the investigators wrote.

SOURCE:

The study was led by Lindsey A. Laytner, PhD, MPH, of the Department of Family and Community Medicine at Baylor College of Medicine, Houston. It was published online on September 23, 2024, in Annals of Family Medicine.

LIMITATIONS: 

The findings may not be entirely applicable to outpatients in less socioeconomically diverse urban regions in the United States. Patients at public clinics may have more complex psychosocial and medical conditions, which may in turn affect their expectations for antibiotics. Social desirability response bias may have occurred despite the neutral phrasing of questions. Unexpected changes associated with the COVID-19 pandemic may have influenced patient antibiotic expectations.

DISCLOSURES:

The study was supported by the Agency for Healthcare Research and Quality. One author reported receiving grants or contracts, payment for a review course, and travel support; another author reported receiving grants or contracts and a research education grant from various sources. Other authors reported no conflicts of interest.

This article was created using several editorial tools, including AI, as part of the process. Human editors reviewed this content before publication.