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Infectious Diseases in Obstetrics and Gynecology
Volume 13, Issue 1, Pages 17-24

Knowledge, Attitudes, and Reported Practices Among Obstetrician-Gynecologists in the USA Regarding Antibiotic Prescribing for Upper Respiratory Tract Infections

1Epidemic Intelligence Service, Division of Applied Public Health Training, Epidemiology Program Office, Centers for Disease Control and Prevention (CDC), Atlanta, GA, USA
2American College of Obstetricians and Gynecologists (ACOG), Department of Research, Washington, DC, USA
3Division of Bacterial and Mycotic Diseases, National Center for Infectious Diseases, CDC, Atlanta, GA, USA
4Division of Maternal-Fetal Medicine, Vincent Memorial Obstetrics and Gynecology, Massachusetts General Hospital, Boston, MA, USA
51600 Clifton Rd, Mailstop E-92, Atlanta, GA 30333, USA

Copyright © 2005 Hindawi Publishing Corporation. This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.


Background: Knowledge, attitudes, and practices regarding antibiotic prescribing for upper respiratory tract infections (URIs) have not been well described among obstetrician-gynecologists (OB/GYNs). This information is useful for determining whether an OB/GYN-specific program promoting appropriate antibiotic use would significantly contribute to the efforts to decrease inappropriate antibiotic use among primary care providers.

Methods: An anonymous questionnaire asking about the treatment of URIs was sent to 1031 obstetrician-gynecologists.

Results: The overall response rate was 46%. The majority of respondents (92%) were aware of the relationship between antibiotic use and antibiotic resistance, and respondents estimated that 5% of their patients had URI symptoms at their office visits. Overall, 56% of respondents reported that they would prescribe an antibiotic for uncomplicated bronchitis and 43% for the common cold. OB/GYNs with the fewest years of experience were less likely than those with the most years of experience to report prescribing for uncomplicated bronchitis (Odds ratio (OR) 0.46, 95% confidence interval (CI) 0.23 to 0.91) or the common cold (OR 0.44, CI 0.22 to 0.89). The majority of respondents (60%) believed that most patients wanted an antibiotic for URI symptoms, with male OB/GYNs being more likely than female OB/GYNs (OR 2.1, CI 1.2 to 3.8) to hold this belief. Both male OB/GYNs (OR 1.9, CI 1.1 to 3.4) and rural practitioners (OR 2.1, CI 1.1 to 4.0) were more likely to believe that it was hard to withhold antibiotics for URI symptoms because other physicians prescribe antibiotics for these symptoms. OB/GYNs who believed that postgraduate training prepared them well for primary care management were more likely than those who did not (OR 2.1, CI 1.1 to 4.2) to believe that they could reduce antibiotic prescribing without reducing patient satisfaction.

Conclusion: Multiple demographic factors affect attitudes and reported practices regarding antibiotic prescribing. However, in view of the low proportion of office visits for URIs, an OB/GYN-specific program is not warranted.