„Fever and Productive Cough“: Symptoms that Trigger Antibiotic Prescriptions by Family Practitioners

german translation / full article

Lisa Schwarz, Angela Schedlbauer, Thomas Kühlein, Susann Hueber

Keywords: acute respiratory family practitioner reasons for prescribing antibiotic tract infection

Background: Decision making with regard to the prescription of antibiotics for acute respiratory tract infections is decisively influenced by patient attributes and symptoms. The aim of this study was to identify the relative importance of such attributes and to find family practitioners with similar prescription behaviour. Furthermore, we were interested in physicians’ confidence in the decisions made for the prescription of antibiotics.Methods: Using an online questionnaire consisting of 16 case vignettes, family practitioners were asked to decide about prescribing antibiotics and to rate their decisional confidence. Five varying attributes were analyzed: age (young/old), sputum (yellow-greenish/bland), duration of disease (short/long), fever (yes/no) and diabetes type 2 (yes/no). The attributes’ relative importance was determined using conjoint analysis. A cluster analysis identified groups with similar prescribing behaviour.Results: The data of 139 participants were used. The mean prescribing rate was 24 %. The confidence in decision making revealed 4.7/6. “Fever” and “yellow-greenish sputum” were the most influential factors. Two groups were identified: doctors of higher age attributed the greatest value to “yellow-greenish sputum”, whereas younger doctors paid more attention to “fever”.Conclusions: The most important decision criteria were fever and yellow-greenish sputum. There seems to be a change in the prioritization of decision criteria away from sputum colour towards fever.

(State: 13.04.2018)

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