Overuse of Antibiotics for URIs: Who is to Blame?
Investigators: Julia Dweck PA-S, Asya Gutman PA-S, Maykl Sher PA-S,
Alyssa Spinosa PA-S, Jessica Teresco PA-S
Advisors: Nora Lowy, PhD, MPA, PA-C & Jenny Sena, MS, PA-C
Antibiotic resistance is on the rise in the United
States, however, many medical providers continue
to prescribe antibiotics for upper respiratory tract
infections (URIs) despite the fact that bacteria
account for only 25% of URIs (Longo et al., 2012).
Even in cases where bacteria are the cause, URIs
are commonly self-limiting diseases and rarely
progress to serious complications (NICE, 2008).
INTRODUCTION
(Q
1
) Is there a difference in knowledge of antibiotic use for URIs between patients and
providers?
(Q
2
) Is there a correlation between patient and provider ‘perception/behavior’ regarding
antibiotic use for URIs?
(Q
3
) Is there a correlation between knowledge and ‘perception/behavior’ of antibiotic
use for URIs?
(H
1
) There is a difference in knowledge of antibiotic use for URIs between patients and
providers.
(H
2
) There is a correlation between patient and provider ‘perception/behavior’ regarding
antibiotic use for URIs.
(H
3
) There is a correlation between knowledge and ‘perception/behavior’ of antibiotic
use for URIs.
Approved by: Wagner College Human
Experimentation Review Board (HERB)
Study Population: Providers and Patients
Distributed at: Medical facilities, Wagner College
campus, and online (SurveyMonkey, Social media)
Instrument Design: Demographics and thirty-nine
5-point Likert scale items consisting of 13
knowledge, 13 perception, and 13 behavior items
BACKGROUND
RESULTS
RESEARCH QUESTIONS
HYPOTHESES
STUDY DESIGN
There is in fact a difference in knowledge of antibiotic use for URIs between patients
and providers. There is also a difference between patient and providers perception and
behavior regarding antibiotic use for URIs. With respect to patients, there is a
correlation between knowledge and perception and behavior of antibiotic use, while on
the other hand, with respect to providers, there is no correlation between knowledge,
and perception and behavior of antibiotic use. Proper patient education should focus on
improving knowledge regarding antibiotics and their indications, while proper provider
education should focus on eliminating misconception regarding patients’ expectations.
CONCLUSION
Wider regional distribution
Increased patient/provider diversity
Limit to private practice providers
Focus on patients’ request for any prescriptions, not
only antibiotics
FUTURE STUDIES
There was a difference in knowledge of antibiotic use between patients (k=3.5/5.0) and
providers (k=4.4/5.0) with a p-value of <0.001. There were also differences in
‘perception/behavior’ regarding antibiotic use (20/26 items) with p-values of <0.05.
With respect to patients, there was a positive correlation between their knowledge and
‘perception/behavior’ (19/26 items) with p-values of <0.05. On the other hand, with
respect to providers, there were only 3/26 items correlating between knowledge and
‘perception/behavior’ of antibiotic use.
“
Each year in the United States, at least 2 million
people become infected with bacteria that are
resistant to antibiotics and at least 23,000 people die
each year as a direct result of these infections.”
CDC, 2016
“….antibiotic resistance is no longer a prediction
for the future; it is happening right now… putting at
risk the ability to treat common infections in the
community and hospital.”
WHO, 2014
“
Respiratory tract infections are the most common
reasons for prescribing
antibacterial agents in
developed countries, representing about 75% of all
prescriptions in community practice.”
Turnidge, 2001
“
Globally, antibiotic resistance is being recognized
as a major healthcare issue… A major concern is
the inappropriate use of antibiotics for non-bacterial
infections and for self-limiting clinical conditions.”
Kotwani & Holloway, 2014
LITERATURE REVIEW
Antibiotics are a class of drugs used solely to treat
bacteria and have no effect on viruses. One of the 1
st
antibiotics ever produced was penicillin. It was discovered
by Alexander Fleming in 1928. It was widely used during
WW2 to treat soldiers’ battlefield wound infections and
pneumonia. Over the decades, antibiotics have been used
for the treatment all kinds of infections. The widespread
use of antibiotics has led us to a major problem known as
antibiotic resistance. The overabundance of antibiotics
prescribed for uncomplicated URIs has become a great
concern in the United States.