Perceptions, attitudes, and practices of French junior physicians regarding antibiotic use and resistance

• Published in: Médecine et maladies infectieuses 2019-06, Vol.49 (4), p.241-249
• Main Authors: Lévin, C., Thilly, N., Dousak, M., Beraud, G., Klesnik, M., Uhan, S., Nathwani, D., Beovic, B., Pulcini, C.
• Format: Article
• Language: English
• Subjects: Adult; Anti-Bacterial Agents - therapeutic use; Antibiotic prescription; Antibiotic stewardship; Antimicrobial Stewardship - methods; Antimicrobial Stewardship - standards; Antimicrobial Stewardship - statistics & numerical data; Attitude of Health Personnel; Bon usage; Drug Resistance, Microbial; Enquête; Female; France - epidemiology; Health Knowledge, Attitudes, Practice; Humans; Junior physicians; Life Sciences; Male; Medical Staff, Hospital - psychology; Medical Staff, Hospital - statistics & numerical data; Perception; Physicians - psychology; Physicians - statistics & numerical data; Practice Patterns, Physicians' - statistics & numerical data; Praticien junior; Prescription antibiotique; Santé publique et épidémiologie; Survey; Surveys and Questionnaires
• ISSN: 0399-077X; 1769-6690
• DOI: 10.1016/j.medmal.2018.09.003

•We conducted an exploratory nationwide cross-sectional questionnaire survey to assess the perceptions, attitudes, and practices of French junior physicians regarding antibiotic use and resistance.•Among the 641 participants, most junior physicians (92.5%) reported being aware that antibiotic resistance was a current and growing problem and most of them (95%) were asking for further training.•Our results suggest that strategies aimed to improve antibiotic use have to be multifaceted and must take into account the role of the “prescribing etiquette” to be efficient. Furthermore, they highlight the importance of antibiotic stewardship programs and the opportunity to bring changes to the junior physician training. To assess the perceptions, attitudes, and practices of French junior physicians regarding antibiotic use and resistance, and then to identify the characteristics of junior physicians associated with appropriate practices of antibiotic use. European junior physicians received an email invitation to complete a 49 item web questionnaire between September 2015 and January 2016. We present the French data. Multivariate regression models were used to identify the characteristics of junior physicians associated with appropriate prescription practices and with consideration of the antibiotic prescription consequences. The questionnaire was completed by 641 junior physicians: family medicine (37%), other medical specialties (e.g., pediatrics, internal medicine, neurology: 45%), surgical specialties (11%), and anesthesiology-intensive care specialty (7%). Most respondents (93%) declared being aware of the risk of bacterial resistance and 41% acknowledged prescribing antibiotics more often than necessary. Two factors were independently associated with appropriate prescription practices: a high perceived level of education on antibiotic use (OR=1.51; 95% CI [1.01–2.30]) and a medical specialty (OR=1.69; 95% CI [1.16–2.46]). Factors independently associated with taking into account adverse events of antibiotics were a good perceived knowledge of antibiotics (OR=3.71; 95% CI [2.09–6.61]), and a high perceived education level on antibiotics (OR=1.70; 95% CI [1.11–2.58]). Our data can help better define interventions targeting junior physicians in antibiotic stewardship programs. Évaluer les perceptions, attitudes et pratiques des internes en médecine concernant les prescriptions antibiotiques et l’antibiorésistance. Identifier les facteurs associés aux bonnes prat