Overuse of antibiotics for the common cold - attitudes and behaviors among doctors in rural areas of Shandong Province, China

Qiang Sun; Dyar, Oliver J.; Lingbo Zhao; Tomson, Göran; Nilsson, Lennart E.; Grape, Malin; Yanyan Song; Ling Yan; Lundborg, Cecilia Stålsby
April 2015
BMC Pharmacology & Toxicology;2015, Vol. 16 Issue 1, p1
Academic Journal
Background: Irrational antibiotic use is common in rural areas of China, despite the growing recognition of the importance of appropriate prescribing to contain antibiotic resistance. The aim of this study was to analyze doctors' attitudes and prescribing practices related to antibiotics in rural areas of Shandong province, focusing on patients with the common cold. Methods: A survey was conducted with doctors working at thirty health facilities (village clinics, township health centers and county general hospitals) in three counties within Shandong province. Questions were included on knowledge and attitudes towards antibiotic prescribing. Separately, a random selection of prescriptions for patients with the common cold was collected from the healthcare institutions at which the doctors worked, to investigate actual prescribing behaviors. Results: A total of 188 doctors completed the survey. Most doctors (83%, 149/180) had attended training on antibiotic use since the beginning of their medical practice as a doctor, irrespective of the academic level of their undergraduate training. Of those that had training, most had attended it within the past three years (97%, 112/116). Very few doctors (2%, 3/187) said they would give antibiotics to a patient with symptoms of a common cold, and the majority (87%, 156/179) would refuse to prescribe an antibiotic even if patients were insistent on getting them. Doctors who had attended training were less likely to give antibiotics in this circumstance (29% vs. 14%, p < 0.001). A diagnosis of common cold was the only diagnosis reported on 1590 out of 8400 prescriptions. Over half (55%, 869/1590) of them included an antibiotic. Prescriptions from village clinics were more likely to contain an antibiotic than those from other healthcare institutions (71% vs. 44% [township] vs. 47% [county], p < 0.001). Conclusions: Most doctors have recently attended training on antibiotic use and report they would not prescribe antibiotics for patients with a common cold, even when placed under pressure by patients. However, more than half of the prescriptions from these healthcare institutions for patients with the common cold included an antibiotic. Exploring and addressing gaps between knowledge and practice is critical to improving antibiotic use in rural China.


Related Articles

  • The effect of essential medicines programme on rational use of medicines in China. Yanhong Gong; Chen Yang; Xiaoxv Yin; Minmin Zhu; Huajie Yang; Yunxia Wang; Yongbin Li; Liqun Liu; Xiaoxin Dong; Shiyi Cao; Zuxun Lu; Gong, Yanhong; Yang, Chen; Yin, Xiaoxv; Zhu, Minmin; Yang, Huajie; Wang, Yunxia; Li, Yongbin; Liu, Liqun; Dong, Xiaoxin // Health Policy & Planning;Feb2016, Vol. 31 Issue 1, p21 

    Objective: Irrational use of medicines is a serious problem in China and has been the primary target of China's national essential medicines programme (NEMP). The aim of this study was to evaluate the effect of the NEMP on rational use of medicines in China.Methods: A...

  • Editorial. Doherty, Tom; Couturier, Francois; Donnelly, Jill; Lavy, Chris // Tropical Doctor;Oct2010, Vol. 40 Issue 4, p193 

    An introduction to the journal is presented in which the guest editors discuss issue about antibiotic prescription at a university hospital in Denmark.

  • Quality of prescribing of intravenous antibiotics in a district general hospital. Denton, Miles; Morgan, Marina S.; White, Ruth R. // BMJ: British Medical Journal (International Edition);2/9/91, Vol. 302 Issue 6772, p327 

    Focuses on the quality survey of prescribing of intravenous antibiotics in a district general hospital. Increase in the use of intravenous cannulas; Responsibility of the nursing staff for giving intravenous antibiotics at night; Difficulty for junior medical staff to give antibiotics at the...

  • New guideline on antibiotic prescribing aims to eliminate unnecessary use.  // Reactions Weekly;1/26/2013, Issue 1436, p3 

    The article reports on the launch by the Danish Health and Medicines Authority of a new guideline on the prescription of antibiotics.

  • Medicines management. Griffith, Matt // Nursing Standard;10/22/2008, Vol. 23 Issue 7, p28 

    The article presents question and answer about the benefits of delayed prescription for antibiotics.

  • Antibiotics not included in new formulary.  // Primary Health Care;Feb2002, Vol. 12 Issue 1, p6 

    Reveals that the Great Britain government's failure to include antibiotics and controlled drugs in the new formulary is not sustainable. List of prescription only medicines that can be prescribed by nurses.

  • Efforts needed to continue judicious use of antibiotics.  // Infectious Disease News;Oct2011, Vol. 24 Issue 10, p21 

    The article focuses on a research study presented at the 2011 Interscience Conference on Antimicrobial Agents and Chemotherapy (ICAAC) held on September 17-20 in Chicago, Illinois which claimed that more efforts are needed to improve judicious antibiotic use.

  • Antibiotics overprescribed among home-care patients in Canada. DeNyse, Ashley // Infectious Disease News;Jul2011, Vol. 24 Issue 7, p42 

    The article reports on the overprescription of antibiotics among home-care patients in Canada.

  • Poor antibiotic prescribing practices still rife in the USA.  // PharmacoEconomics & Outcomes News;10/19/2013, Issue 689, p10 

    The article presents the results of a research letter published in the "JAMA Internal Medicine" on the incremental improvement for adults making a clinic visit with a sore throat as well as the poor antibiotic prescription practices in the U.S. despite effort to advance prescribing.


Read the Article


Sorry, but this item is not currently available from your library.

Try another library?
Sign out of this library

Other Topics