[The physician, patient and antibiotics].

More than 3.000 randomized patients, who received an antibiotic course for a mild respiratory infection in the last 2 months have been interviewed in 4 European countries about their perceptions of antibiotic therapy and the doctor's skills. Six attitudinal dimensions related to the doctor identified 4 patients type: Involved (30 %), Deferents (23%), Ignored (13%) and Critical (17%). Involved and Deferent patients knew better the rules of good antibiotic use (p<0,01), were more compliant (p<0,01), and received more accurater information from the doctor (p<0,01). Ignored patients keep left over antibiotics for uncontrolled further use most often (p<0,01). A large majority of patients, whatever the category, believed that a flu should be treated with an antibiotic. Germany includes more involved patients, the highest rate of confidence in physician's skills, who was the most informative, but they also had less people knowing the uselessness of antibiotics in flu. Spaniards had more propensity to expect antibiotics from their doctor, showed the lesser level of confidence in their physician's skill, and were the most prone to claim for the benign character of their infection. Critical patients were mostly recruited in France and Italy which also includes the highest rate of ignored patients. French patients were by far the less likely to receive accurate information from their physician. In conclusion, an actual educational deficit has been found in the patients regarding antibiotic use. The physician is in the best position for correcting the deficit. By implicating more the patients in the medical decision, he or she will deflate the ignored category, the most likely to misuse antibiotics, and hence to produce antibiotic resistance.

RCT Entities:   Population Interventions Outcomes