General Practitioners’, Pharmacists’ and Parents’ Views on Antibiotic Use and Resistance in Malta: An Exploratory Qualitative Study

Abstract

Background: Antibiotic resistance (ABR) remains a global health threat that requires urgent action. Antibiotic use is a key driver of ABR and is particularly problematic in the outpatient setting. General practitioners (GPs), the public, and pharmacists therefore play an important role in safeguarding antibiotics. In this study, we aimed to gain a better understanding of the antibiotic prescribing-use-dispensation dynamic in Malta from the perspective of GPs, pharmacists, and parents; Methods: we conducted 8 focus groups with 8 GPs, 24 pharmacists, and 18 parents between 2014 and 2016. Data were analysed using inductive and deductive content analysis; Results: Awareness on antibiotic overuse and ABR was generally high among interviewees although antibiotic use was thought to be improving. Despite this, some believed that antibiotic demand, non-compliance, and over-the-counter dispensing are still a problem. Nevertheless, interviewees believed that the public is more accepting of alternative strategies, such as delayed antibiotic prescription. Both GPs and pharmacists were enthusiastic about their roles as patient educators in raising knowledge and awareness in this context; Conclusions: While antibiotic use and misuse, and knowledge and awareness, were perceived to have improved in Malta, our study suggests that even though stakeholders indicated willingness to drive change, there is still much room for improvement.

Determinants of the Empiric Use of Antibiotics by General Practitioners in South Africa: Observational, Analytic, Cross-Sectional Study

“…Alternatively, they are less confident dealing with demanding patients who expect an antibiotic. However, a study in Malta found older GPs exhibited habitual prescribing behaviour, relying on experience more than guidelines for their prescribing whereas younger GPs were more guideline-concordant [ 114 ]. In addition, the case mix may be different between younger and older GPs, with elderly patients more likely to visit more elderly GPs.…”

Outcomes of antibiotic treatment for respiratory infections in children an observational study in primary care

“…Research suggests that more than half of such infections are viral [ 8–10 ]. Following the development of vaccines targeting bacteria such as S. pneumoniae and H. influenzae type B, bacterial infections have decreased [ 11–13 ]. Some bacterial infections may be more self-limiting than previously assumed.…”

Potential Factors of Primary Hospital Healthcare Professionals in Hindering the Abolition of Routine Skin Test for Cephalosporin: A Cross-Sectional Study

“…In addition, the results also showed that respondents in older age, with high educational backgrounds or high professional qualification tended to obtain higher score in the "Knowledge" part, which consistent with previous studies on the rationale use of antibiotics. [21][22][23] These factors suggest that knowledge about the cephalosporin skin test should be enforced early in the career of the healthcare workers. Pharmacists scored highest for knowledge of medicines, which is logical base on the content of their work.…”

“…Similar results were observed for antimicrobial stewardship. [21][22][23] Furthermore, doctors order skin tests, while nurses are usually the ones who perform them, which leading to knowledge differences. Therefore, appropriate training should be conducted to doctors and nurses.…”

“…In addition, the investigation results of this study also revealed that in terms of the enabling factors, doctors scored the lowest, followed by nurses, and pharmacists scored the highest, as supported by previous studies on antibiotics use. [21][22][23] Thus, it is necessary to further strengthen the healthcare workers' recognition of the abolishing of the RSTC. While offering training programs, the hospital should place stress on doctors and nurses, especially young doctors and nurses with fewer years of work.…”