Houston—If pharmacists and other healthcare professionals took the time to educate patients about the risks presented by antibiotic use, it might be easier for providers to refuse to prescribe them for common symptoms.

That is according to a new study in the Annals of Family Medicine, which pointed out, “Patient expectations of receiving antibiotics for common symptoms can trigger unnecessary use.”

A Baylor College of Medicine–led study team conducted a survey from January 2020 to June 2021 of 564 patients in public and private primary care clinics in Texas. The goal was to study the prevalence and predictors of patients’ antibiotic expectations for common symptoms/illnesses.

The study examined the 1) prevalence of patient antibiotic expectations for acute diarrhea, sore throat, cold/flu, sinus infection, and bronchitis symptoms/illnesses; 2) differences in the prevalence of patient antibiotic expectations between primary care patients in a public and private healthcare system; and 3) predictors of patients’ antibiotic expectations for each symptom/illness.

“We surveyed black patients (33%) and Hispanic/Latino patients (47%), and over 93% expected to receive an antibiotic for at least 1 of the 5 pre-defined symptoms/illnesses,” the researchers reported. They added that public clinic patients were nearly twice as likely to expect antibiotics for sore throat, diarrhea and cold/flu than private clinic patients.

“Lack of knowledge of potential risks of antibiotic use was associated with increased antibiotic expectations for diarrhea (odds ratio [OR] = 1.6; 95% CI, 1.1-2.4) and cold/flu symptoms (OR = 2.9; 95% CI, 2.0-4.4),” the researchers explained. “Lower education and inadequate health literacy were predictors of antibiotic expectations for diarrhea. Future antibiotic stewardship interventions should tailor patient education materials to include information on antibiotic risks and guidance on appropriate antibiotic indications.”

Background information in the article advised that patients often receive antibiotic prescriptions to treat common viral symptoms/illnesses, such as respiratory tract infection, cold/flu, and diarrhea, despite guidelines recommending against these practices.

“Individuals’ knowledge, beliefs, and expectations may contribute to inappropriate antibiotic use,” the report noted. “These prior studies, however, did not examine the independent effects of knowledge of antibiotic risks and sociodemographic factors on patient expectations of antibiotics for common symptoms/illnesses.”

The authors concluded that differences in patient education, knowledge of harms/risks, health literacy and the healthcare system itself can foster inappropriate patient expectations of antibiotics for common symptoms.

The study advised that future stewardship interventions to reduce inappropriate patient antibiotic expectations should inform patients of the symptoms/illnesses that antibiotics treat and emphasized the individual harms/risks of antibiotics to themselves or those close to them.

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