The Impact of Antibiotic Usage Guidelines, Developed and Disseminated through Internet, on the Knowledge, Attitude and Prescribing Habits of Orthokeratology Contact Lens Practitioners in China.

Zhi Chen,Jifang Wang,Pauline Cho,Bi Yang,Jun Jiang

doi:10.3390/antibiotics11020179

Abstract

It has been previously reported that the improper prescribing of antibiotic eye drops is common among orthokeratology (ortho-k) practitioners. Guidelines have since been developed and disseminated to improve their understanding and implementation of antibiotic prescriptions. This study aimed to investigate the influence of these guidelines on the knowledge, attitude, and prescribing habits of ortho-k practitioners by means of a questionnaire, which was administered nationwide via an official online account to eye care practitioners (ECPs) involved in ortho-k lens fitting, 548 of whom completed the survey. Differences in characteristics before and after the dissemination of the guidelines and between the groups were explored using χ2 tests. The relationship between prescribing habits and demographics was analyzed using stepwise logistic regression models. The implementation of the guidelines significantly improved the overall prescribing habits of ECPs (p < 0.001), especially for prophylactic antibiotic use before and after ortho-k lens wear (p < 0.001). Most ECPs who prescribed antibiotics properly displayed significantly better knowledge of correct antibiotic use, which in turn affected the compliance in their ortho-k patients (p < 0.001). The ECPs’ occupations (professionals other than ophthalmologists and optometrists, including nurses and opticians), clinical setting (distributor fitting centers), and age (younger than 25 years) were risk factors for the misuse of antibiotics. Although the implementation of the antibiotic guidelines significantly improved overall prescribing habits, some practitioners’ prescribing behavior still needs improvement. A limitation of this study was that all questions were mandatory, requiring ECPs to recall information, and therefore was subjected to selection and recall bias.

Highlights

Introduction distributed under the terms andOrthokeratology employs specially designed rigid gas-permeable contact lenses, worn overnight to correct myopic refractive error during the day through temporary molding of the cornea [1]
The results indicated that the misuse or improper use of antibiotic eye drops is common among eye care practitioners (ECPs) [11]
The reinforcement of the importance of proper antibiotic use in ortho-k practice lasted for six months, mainly through online education. As these guidelines were promulgated for six months, the purpose of this study was to investigate their effect on knowledge, attitude, and behavioral change in antibiotic use among ortho-k ECPs in China

Summary

Introduction

Orthokeratology (ortho-k) employs specially designed rigid gas-permeable contact lenses, worn overnight to correct myopic refractive error during the day through temporary molding of the cornea [1]. Redistribution of corneal epithelial cells [2], resulting in central flattening and midperipheral steepening [3]. In addition to this vision-correcting function, ortho-k has been shown to slow myopia progression in children and juveniles. Studies have shown its myopia control efficacy, based on the percentage of axial elongation reduction, to range from 36% to 46% [4,5,6,7]. Ortho-k has become the most accessible and popular myopia control modality in China, with over 1.5 million users in 2016 [8].

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