Impact of Education on Inappropriate Antibiotic Prescription for Respiratory Tract Infection Based on Physicians’ Justifications: A Web-Based Survey in Japan
Ryohei Kudoh,
Kosaku Komiya,
Norihito Kaku,
Yuichiro Shindo,
Tatsuya Hayashi,
Kei Kasahara,
Tomohiro Oishi,
Naruhiko Ishiwada,
Makoto Ito,
Hiroshi Yotsuyanagi,
Naoki Hasegawa,
Kazuhiro Tateda,
Muneki Hotomi,
Katsunori Yanagihara
Affiliations
Ryohei Kudoh
Respiratory Medicine and Infectious Diseases, Oita University Faculty of Medicine, 1-1 Idaigaoka, Hasama-machi, Yufu, Oita 879-5593, Japan
Kosaku Komiya
Respiratory Medicine and Infectious Diseases, Oita University Faculty of Medicine, 1-1 Idaigaoka, Hasama-machi, Yufu, Oita 879-5593, Japan
Norihito Kaku
Department of Laboratory Medicine, Nagasaki University Hospital, 1-7-1 Sakamoto, Nagasaki 852-8501, Japan
Yuichiro Shindo
Department of Respiratory Medicine, Nagoya University Graduate School of Medicine, 65 Tsurumai-cho, Showa-ku, Nagoya 466-8550, Japan
Tatsuya Hayashi
Department of Otolaryngology-Head and Neck Surgery, Asahikawa Medical University, Midorigaoka Higashi 2-1-1-1, Asahikawa 078-8510, Japan
Kei Kasahara
Department of Infectious Diseases, Nara Medical University, 840 Shijo-cho, Kashihara, Nara 634-8521, Japan
Tomohiro Oishi
Department of Clinical Infectious Diseases, Kawasaki Medical School, 577 Matsuyama, Kurashiki 701-0192, Japan
Naruhiko Ishiwada
Department of Infectious Diseases, Medical Mycology Research Center, Chiba University, 1-8-1 Inohana, Chuo-ku, Chiba 260-8673, Japan
Makoto Ito
Department of Otolaryngology and Head and Neck Surgery, Jichi Medical University, 3311-1 Yakushiji, Shimotsuke-shi, Tochigi 329-0431, Japan
Hiroshi Yotsuyanagi
Department of Infectious Diseases and Applied Immunology, IMSUT Hospital, Institute of Medical Science, University of Tokyo, 4-6-1 Shirokanedai, Minato-ku, Tokyo 108-8639, Japan
Naoki Hasegawa
Department of Infectious Diseases, Keio University School of Medicine, 35 Shinano-machi, Shinjuku-ku, Tokyo 160-8582, Japan
Kazuhiro Tateda
Department of Microbiology and Infectious Disease, Toho University School of Medicine, 5-21-16 Omori-nishi, Ota-ku, Tokyo 143-8540, Japan
Muneki Hotomi
Department of Otorhinolaryngology-Head and Neck Surgery, Wakayama Medical University, 811-1 Kimiidera, Wakayama 641-8509, Japan
Katsunori Yanagihara
Department of Laboratory Medicine, Nagasaki University Hospital, 1-7-1 Sakamoto, Nagasaki 852-8501, Japan
Background: Antibiotics are inappropriately prescribed for respiratory tract infections for various reasons. The differences of the effects of education based on these reasons has not been fully elucidated. This study assessed the impact of an educational film on antibiotic prescription patterns according to physicians’ prescribing justifications. Methods: This was a secondary analysis of a nationwide web-based survey involving 1100 physicians. The physicians were required to view a short educational film and determine the need for prescribing antibiotics in simulated scenarios of different acute respiratory tract infectious diseases. The associations between the reasons for antibiotic prescription to patients not requiring antibiotics before viewing the educational film and the positive effects of the intervention were analyzed. Results: The educational intervention positively affected prescribing trends among physicians who prescribed antibiotics for “fever” in mild acute rhinosinusitis (prescription rates from 100% to 25.9%), “pus in the laryngopharynx” in mild acute pharyngitis (prescription rates from 100% to 29.6%), and “purulent sputum” in acute bronchitis without chronic lung disease (prescription rates from 100% to 29.9%) before viewing the film. In contrast, no benefits were observed when the justification was “patient’s desire for antibiotics” in mild acute pharyngitis (prescription rates from 100% to 48.5%) and acute bronchitis without chronic lung disease (prescription rates from 100% to 44.0%) or “parents’ desire for antibiotics” in narrowly defined common cold in children (prescription rates from 100% to 45.7%). Conclusions: although educational interventions might reduce inappropriate antibiotic prescription by providing accurate knowledge about respiratory tract infections, they appear ineffective for physicians who prescribe antibiotics based on patients’ or parents’ desires for antibiotic treatment.
