Antibiotic Prescribing Practices to Children Among in- and Outpatient Physicians in Bulgaria

Abstract Assessing the particular trends and factors influencing antibiotic prescription practices for pediatric patients by inpatient and outpatient physicians in Bulgaria is essential for pinpointing areas needing improvement and devising strategies to encourage judicious use of antibiotics. The aim of this study is to offer practical insights for both hospital and outpatient care. By recognizing and comprehending the specific details of antibiotic usage in pediatric healthcare, this study seeks to facilitate the creation of tailored stew-ardship strategies to address the growing challenge of antimicrobial resistance. A cross-sectional, multicenter survey was conducted between September and November 2022, involving specialists from various medical fields. The study used a 4-point Likert scale to evaluate the most prevalent clinical scenarios in which antibiotics were prescribed. A total of 222 physicians participated in the survey, with 108 respondents chosen for analysis. Their primary patient population consisted of at least 25% children. The study’s results highlight notable variations in antibiotic prescription patterns between general practitioners and outpatient physicians in Bulgaria. Specifically, general practitioners were found to have a higher tendency to prescribe antibiotics before holidays or weekends compared to outpatient physicians. Moreover, GPs in Bulgaria displayed an increased likelihood of prescribing antibiotics when they had personal familiarity with the patient and did not consider further tests necessary. They also exhibited lower rates of prescribing antibiotics based on antibiogram and blood test results compared to outpatient physicians. Healthcare providers play a crucial role in addressing antimicrobial resistance, highlighting the necessity of their proactive participation in combating this global health concern. Despite being aware of the issue, there is need for additional education and interventions to enhance appropriate prescribing practices. The authors underline the significance of adopting a well-balanced approach to antibiotic prescription, taking into account both individual patient requirements and potential public health implications associated with antibiotic misuse.