The perception of the physician by the patient , an indicator of patients' attitudes towards their antibiotic treatment

Jean- Claude Pechère , president of the International Society of chemotherapy and corresponding member of National Academy of Medicine , presented the results of a European survey showing that the perception of the physician by the patient affects the attitude of the last in terms of consumption of antibiotics
survey
The survey was presented at the press conference in the preamble of the thematic session of the National Academy of Medicine devoted to proper use of antibiotics .

Conducted in 2002 in four European countries (Germany, Spain, Italy, France ) , the survey was conducted with the support of a UK survey, which has participated in the development of 120 questions that participants had to answer . In each country were interviewed 600 adults who were faced with a mild respiratory infection treated with antibiotics in the two months preceding the survey , and 200 persons responsible for a child aged 18 months to 12 years who have experienced the same position .

Analysis of the responses to the questionnaire ( on the socio -demographic characteristics of the subject, the condition being treated , and the perception of the attitude of their doctor ) has identified four categories of patients , depending on their attitude à-vis their relationship with their physician , said Jean -Claude Pechère .

Four profiles - type patients
First category of patients identified through this study: "involved sick." Slightly older than the other patients , they actively participate in their own care, particularly regarding decisions about their health. According to the records of the survey , 30% of Europeans surveyed fall under this scheme, which is more common in Germany (43% of respondents , against 31% in France ) .

The " vas sick " consider for their physician as an expert and " comply with its requirements ," added Jean- Claude Pechère . A little older than the average, they represent nearly a quarter of respondents ( 23%) and are more common in France (34%) and Spain ( 32%).

In terms of consumption of antibiotics , these first two categories together "good patients who do not have bad habits ," noted Jean- Claude Pechère , while the following two frequently exhibit behaviors.

Thus, the " ignored sick " does not have good contact with their doctor which they assume it does not listen or do not believe (13 % on average , 44 % in Italy and 12% in France ) while " critically ill " , which are characterized by a level higher than the average participant education, doubt his skills. They are particularly numerous in France (35%) and Italy ( 34%).

The evaluation of the behavior of these different types of patient in terms of consumption of antibiotics has emphasized that these are two categories who know the least about the rules for the proper use of antibiotics. Indeed, the " unknown " and "critical" are significantly less likely to show good adherence to treatment .

But quitting treatment before the end or not to comply with the number of shots daily - even if symptoms disappear will provide bacteria conditions " ideal to become resistant ," said Didier Pittet, prevention service and infection control at the University Hospitals of Geneva ( Switzerland). Indeed , the decrease in blood concentrations of antibiotics derived from this approach eliminates sensitive bacteria without affecting the resistant bacteria , which then proliferate freely.

In addition , 80% of " ignored " acceptable to keep an antibiotic not used for later use , attitude criticized by specialists present. Indeed, this habit of self-prescription later is often the cause of an unjustified use of antibiotics ( for colds, sore throat , cough, or viral infection) that participates in the development of resistance .

Another disturbing fact: whatever the group of patients seen , almost eight out of ten people believe that flu (viral illness) should be treated with antibiotics ( products intended to fight against bacteria ) .

Antibiotics ... less automatic
Patrick Choutet , the infectious diseases hospital Bretonneau CHU Tours ( Indre-et- Loire), however, pointed out that France , the information campaign since 2002 with the slogan " antibiotics, c ' is not automatic " helped rectify .

Indeed, the repetition of this information and awareness campaign about the risks of overuse of antibiotics has reduced antibiotic prescriptions by 11.4% during the winter of 2002-2003 compared to the previous year , and a further reduction of 5.4 % between the 2002-2003 season and the next.

The polls also showed an improvement in the knowledge of the general public on antibiotics, confirming the effectiveness of the campaign.

However, this tends to reduce the use of antibiotics to keep this campaign "should be relayed by the doctors ," said Jean- Claude Pechère . Based on the results of the European he was the instigator study, he insisted that doctors , identifying profiles of patients may try to improve their relationship by involving patients falling risk categories of misuse of antibiotics.

The practitioner " can go from worst to best regarding the use of antibiotics , namely the category of ignored that involved," he summarized .