| Abstract | CILJ ISTRAŽIVANJA: Glavni cilj ovog istraživanja bio je procijeniti stavove i znanja liječnika obiteljske medicine Splitsko-dalmatinske županije o propisivanju antibiotske terapije COVID-19 oboljelim pacijentima, te upoznatost sa najrecentnijim smjernicama za liječenje koronavirusne bolesti i nadomjesnom terapijom vitaminom D.
ISPITANICI I METODE: Provedeno je istraživanje u svrhu ispitivanja stavova i znanja liječnika obiteljske medicine Splitsko-dalmatinske županije o upotrebi antibiotske terapije kod COVID-19 pozitivnih osoba. Podaci su prikupljeni pomoću anketnog upitnika kojem se pristupalo putem Google forms internetske aplikacije tijekom svibnja 2022. Upitnik se sastojao od 23 pitanja. Za analizu podataka korišten je statistički software STATISTICA 12, Tibco, Kalifornija.
REZULTATI: Sa zadnjim smjernicama za liječenje oboljelih od koronavirusne bolesti (verzija 5 od 8.veljače 2022. godine) je upoznato 100 (87%) liječnika obiteljske medicine. Od 115 liječnika, njih 88 (77,2%) se u potpunosti slaže sa preporukom da je osnova liječenja COVID-19 infekcije ublažavanje simptoma, sprječavanje komplikacija i progresije bolesti te simptomatsko i suportivno liječenje. Najveći broj LOM smatra da su propisali antibiotsku terapiju za 10-30% oboljelih (41,67%). Na pitanje o izboru i trajanju antibiotske terapije kod COVID-19 pozitivnih pacijenata 80 (70,80%) LOM bi se odlučilo na makrolide (azitromicin) u trajanju od 3 dana, njih 20 (17,70%) na makrolide (azitromicin) u trajanju od 5 do 6 dana, a njih 13 (11,50%) bi se odlučilo na neku drugu skupinu antibiotika. Ispitivanjem nije utvrđena povezanost između odabira i trajanja antibiotske terapije s obzirom na dob (P=0,182) i specijalistički status liječnika (P=0,650). Ispitivanjem je utvrđena statistički značajna razlika u zastupljenosti stava liječnika kako nitko iz skupine pacijenata sa nekompliciranom infekcijom koji može imati vrućicu, opću slabost, glavobolju, mialgiju, hunjavicu, grlobolju i/ili kašalj ne treba dobiti antibiotik (P<0,001). Najčešći razlog propisivanja antibiotske terapije pacijentima su bili pritisak pacijenta (57%) i otkriveni komorbiditeti na osnovi fizikalnog pregleda i/ili laboratorijskih nalaza (66,7%). Ispitivanjem nije utvrđena prisutnost statistički značajne razlike u propisivanju ili preporučivanju nadomjesne terapije vitaminom D s obzirom na životnu dob liječnika (P=0,142) ni na specijalistički status (P=0,199).
ZAKLJUČCI: Studijom je pokazano da liječnici Splitsko-dalmatinske županije u velikoj mjeri propisuju antibiotsku terapiju svojim pacijentima oboljelim od koronavirusne bolesti, neovisno o specijalstičkom statusu, starosnoj dobi ili broju pacijenata u timu. Također, potrebno je unaprijediti smjernice kako bi se olakšao rad liječnika obiteljske medicine i kako bi se smanjilo neopravdano propisivanje antibiotske terapije. |
| Abstract (english) | OBJECTIVES: The main goal of this research was to assess the attitudes and knowledge of family medicine doctors in the Split-Dalmatia County regarding the prescription of antibiotic therapy to patients with COVID-19, as well as their familiarity with the most recent guidelines for the treatment of coronavirus disease and vitamin D replacement therapy.
PATIENTS AND METHODS: A study was conducted to examine the attitudes and knowledge of family medicine doctors in the Split-Dalmatia County regarding the use of antibiotic therapy in COVID-19 positive patients. The data was collected by solving a questionnaire via the Google forms internet application during May 2022. The questionnaire consisted of 23 questions. The statistical software STATISTICA 12, Tibco, California, was used for data analysis.
RESULTS: The majority of family medicine doctors, 100 (87%), are familiar with the latest guidelines for the treatment of patients with the coronavirus disease (version 5 of February 8, 2022). Out of 115 doctors, 88 of them (77.2%) fully agree with the recommendation that the basis of the treatment of the COVID-19 infection is the alleviation of symptoms, complications and progression of the disease, as well as symptomatic and supportive treatment. The largest number of LOMs believe that they prescribed antibiotic therapy for 10-30% of patients (41.67%). When asked about the choice and duration of antibiotic therapy in COVID-19 positive patients, 80 (70.80%) LOM would decide on a macrolide (azithromycin) for 3 days, 20 of them (17.70%) on a macrolide (azithromycin) in lasting from 5 to 6 days, and 13 of them (11.50%) would have opted for another group of antibiotics. The examination did not establish a connection between the selection and duration of antibiotic therapy with regard to age (P=0.182) and specialist status of the doctor (P=0.650). The examination revealed a statistically significant difference in the representation of the physician's opinion that no one from the group of patients with an uncomplicated infection who may have fever, general weakness, headache, myalgia, wheezing, sore throat and/or cough should receive antibiotics (P<0.001). The most common reason for prescribing antibiotic therapy to patients was patient pressure (57%) and detected comorbidities based on physical examination and/or laboratory findings (66.7%). The study did not establish the presence of statistically significant differences in prescribing or recommending vitamin D replacement therapy with regard to the doctor's age (P=0.142) or specialist status (P=0.199).
CONCLUSIONS: The study showed that doctors in the Split-Dalmatia County largely prescribe antibiotic therapy to their patients suffering from the coronavirus disease, regardless of specialist status, age or the number of patients in the team. Also, it is necessary to improve the guidelines in order to facilitate the work of the family doctors and to reduce the unjustified prescription of antibiotic therapy. |
