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Socially responsible antibiotic choices in primary care: a qualitative study of GPs' decisions to prescribe broad-spectrum and fluroquinolone antibiotics.
Fam Pract. 2007 Oct; 24(5):427-34.FP

Abstract

BACKGROUND

There is considerable variation within and between countries in general medical practitioners' (GPs') prescribing of broad-spectrum antibiotics such as fluroquinolones, and resistance to these agents is increasing worldwide. Urgently promoting cautious fluroquinolone prescribing in primary care may limit increase in resistance.

OBJECTIVE

We therefore interviewed 40 GPs in order to explore the reasons for their choice of prescribed antibiotic, in particular their decision to prescribe fluroquinolones.

METHODS

We used a grounded theory approach to data collection and analysis, incorporating purposive and theoretical sampling, based on high and average fluroquinolone prescribing. Interviews were conducted with 26 GPs from practices known to be high prescribers of fluroquinolone antibiotics and 14 from average fluroquinolone prescribing practices.

RESULTS

Chosing to prescribe a broad-spectrum antibiotic such as a fluroquinolone, rather than a narrow-spectrum antibiotic, related to a number of clinical considerations, perceptions of patient expectations and organizational influences. GPs from high fluroquinolone prescribing practices were more likely to prioritize patients' immediate needs, whereas GPs from average prescribing practices were more likely to consider longer term issues. GPs from both high and average fluroquinolone prescribing practices justified their antibiotic choices on the basis of a desire to do their best for their patients and society.

CONCLUSION

Choosing to prescribe powerful, broad-spectrum antibiotics such as fluroquinolones, as well as choosing to keep these agents in reserve, was justified on the basis of social responsibility. Strategies to change fluroquinolone and broad-spectrum antibiotic prescribing will need to take into account clinicians' perceptions of social responsibility.

Authors+Show Affiliations

Department of Primary Care and Public Health, Cardiff University, Neuadd Meirionydd, Heath Park, Cardiff, Wales, UK. wood@cardiff.ac.ukNo affiliation info availableNo affiliation info available

Pub Type(s)

Journal Article
Research Support, Non-U.S. Gov't

Language

eng

PubMed ID

17728289

Citation

Wood, Fiona, et al. "Socially Responsible Antibiotic Choices in Primary Care: a Qualitative Study of GPs' Decisions to Prescribe Broad-spectrum and Fluroquinolone Antibiotics." Family Practice, vol. 24, no. 5, 2007, pp. 427-34.
Wood F, Simpson S, Butler CC. Socially responsible antibiotic choices in primary care: a qualitative study of GPs' decisions to prescribe broad-spectrum and fluroquinolone antibiotics. Fam Pract. 2007;24(5):427-34.
Wood, F., Simpson, S., & Butler, C. C. (2007). Socially responsible antibiotic choices in primary care: a qualitative study of GPs' decisions to prescribe broad-spectrum and fluroquinolone antibiotics. Family Practice, 24(5), 427-34.
Wood F, Simpson S, Butler CC. Socially Responsible Antibiotic Choices in Primary Care: a Qualitative Study of GPs' Decisions to Prescribe Broad-spectrum and Fluroquinolone Antibiotics. Fam Pract. 2007;24(5):427-34. PubMed PMID: 17728289.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Socially responsible antibiotic choices in primary care: a qualitative study of GPs' decisions to prescribe broad-spectrum and fluroquinolone antibiotics. AU - Wood,Fiona, AU - Simpson,Sharon, AU - Butler,Christopher C, Y1 - 2007/08/28/ PY - 2007/8/31/pubmed PY - 2008/3/26/medline PY - 2007/8/31/entrez SP - 427 EP - 34 JF - Family practice JO - Fam Pract VL - 24 IS - 5 N2 - BACKGROUND: There is considerable variation within and between countries in general medical practitioners' (GPs') prescribing of broad-spectrum antibiotics such as fluroquinolones, and resistance to these agents is increasing worldwide. Urgently promoting cautious fluroquinolone prescribing in primary care may limit increase in resistance. OBJECTIVE: We therefore interviewed 40 GPs in order to explore the reasons for their choice of prescribed antibiotic, in particular their decision to prescribe fluroquinolones. METHODS: We used a grounded theory approach to data collection and analysis, incorporating purposive and theoretical sampling, based on high and average fluroquinolone prescribing. Interviews were conducted with 26 GPs from practices known to be high prescribers of fluroquinolone antibiotics and 14 from average fluroquinolone prescribing practices. RESULTS: Chosing to prescribe a broad-spectrum antibiotic such as a fluroquinolone, rather than a narrow-spectrum antibiotic, related to a number of clinical considerations, perceptions of patient expectations and organizational influences. GPs from high fluroquinolone prescribing practices were more likely to prioritize patients' immediate needs, whereas GPs from average prescribing practices were more likely to consider longer term issues. GPs from both high and average fluroquinolone prescribing practices justified their antibiotic choices on the basis of a desire to do their best for their patients and society. CONCLUSION: Choosing to prescribe powerful, broad-spectrum antibiotics such as fluroquinolones, as well as choosing to keep these agents in reserve, was justified on the basis of social responsibility. Strategies to change fluroquinolone and broad-spectrum antibiotic prescribing will need to take into account clinicians' perceptions of social responsibility. SN - 0263-2136 UR - https://www.unboundmedicine.com/medline/citation/17728289/Socially_responsible_antibiotic_choices_in_primary_care:_a_qualitative_study_of_GPs'_decisions_to_prescribe_broad_spectrum_and_fluroquinolone_antibiotics_ L2 - https://academic.oup.com/fampra/article-lookup/doi/10.1093/fampra/cmm040 DB - PRIME DP - Unbound Medicine ER -