Quels sont les déterminants des comportements des prescripteurs d'antibiotiques ?

Abstract

Appropriate antibiotic prescriptions should rely on scientific objective criteria. Theoretically, every infection is expected to be accurately diagnosed and treated using antimicrobials with strictly determined type, administration mode, dosage, and length of treatment. Actually, every day brings evidence that antibiotic prescriptions are often ruled by non-scientific factors linked to the physician's behavior. Irrational prescriptions, far from scientific rigor, result from a lack of or a poor diagnosis, insufficiently documented severity of illnesses, the anxiety of physicians whose knowledge of antibiotic use is often limited. These 3 trends bring to overcautious, over-prescriptions, most of the time inappropriate and unjustified. Reaching better standards in antibiotic use entails improving diagnosis skill and evaluation of the patient's status and illness, under and post-graduate education programs in which the pharmaceutical firms play an important part, development of paper/software aids to prescription, guidelines and rules for treatment and audit of prescription habits by infectious disease experts.