Antibiotic Use Among Belgian Ear, Nose, and Throat Specialists: A Survey-Based Analysis

Background: Antimicrobial resistance (AMR) is a growing global health threat, partly driven by inappropriate antibiotic use. Despite frequent management of infectious conditions, little is known about antibiotic prescribing practices among ear, nose, and throat (ENT) physicians in Belgium. Methods: A national, anonymous survey was conducted between March and August 2024 among ENT physicians and residents in Belgium. The questionnaire assessed demographics, prescribing motivations, perceptions of AMR, and decision-making in 4 cases. Data were analyzed using descriptive statistics and associations were evaluated using frequencies, percentages, and γ tests. Results:One hundred thirty-nine respondents completed the survey (response rate of 14.1%). Most were specialists (76.3%, n = 106) and worked in peripheral hospitals (71.2%, n = 99). While 71.2% reported using guidelines in the past month, 54.7% indicated a preference for clinical experience over guideline adherence. Residents and university-affiliated ENT physicians were significantly more guideline-compliant (γ = 0.316, P = .028). Although 96.4% acknowledged AMR as a global issue, nearly half (48.9%) remained neutral regarding their personal contribution to its development. Conclusion: Belgian ENT physicians balance guideline use with clinical experience when prescribing antibiotics. While general awareness of AMR is high, individual accountability is less recognized. Strengthening awareness of personal prescribing impact and supporting collaboration between peripheral and academic centers may enhance antimicrobial management in otolaryngology. However, these findings should be interpreted with caution because of the modest response rate and disproportionate representation of ENT residents.