Leading prescriber change

RTIs are very common in the community and the risk of inappropriate antibiotic usage is very high, said Dr Aurelio Sessa, General Practitioner and Professor of Family Medicine at Insubria University, Varese, Italy. According to the latest European Centre for Disease Prevention and Control report, all prescribers are implicated in addressing the overuse of antibiotics and the risk of AMR both in the hospital and community setting.

A recent customer survey showed some 34% of people took an oral antibiotic in the last 12 months within Italy, although
there is a geographical split with higher prescription and consumption of antibiotics in the Mediterranean region and less usage in the north. The majority of antibiotics are
prescribed in the primary care setting.

Doctors’ and patients’ beliefs and attitudes influence the level of prescriptions, said Dr Sessa. From a physician’s perspective, sometimes there is uncertainty surrounding the diagnosis. Often, time allowed for consultations is too short to give sufficient explanation to the patient. 

Sometimes doctors are reluctant to deny the patient an antibiotic, as this may impair the doctor-patient relationship. From a patient’s perspective, there is often insufficient health literacy. Patients may have had previous success with an antibiotic therapy and believe that a new respiratory infection can be treated with another antibiotic. Sometimes the patient may have some residual antibiotic pills from a previous prescription at home, or will go to a pharmacy that dispenses antibiotics without need for prescription.

Dr Sessa shared the results of a case study where the GRIP materials were used in an Italian GP surgery. Over a period of three months, the toolkit was used with 185 individual patients resulting in a reduction in the number of antibiotic prescriptions compared to when the toolkit wasn’t used. This shows the value of using toolkits to assist in giving explanations to patients, particularly when the doctor has the perception that the patient wants an antibiotic for their sore throat. Dr Sessa cautioned that every time a doctor prescribes an antibiotic, they must pause to ask if it is truly the correct decision.