Diagnostic Uncertainty And Antibiotic Prescribing By Doctors In Primary Care In Lubumbashi

Abstract

Context and Objective : This study was conducted to investigate diagnostic uncertainty in antibiotic prescribing and its consequences on infection management. Methods : A survey using open-ended interviews based on a paper guide questionnaire (handed out in person) and online via Google Forms among the 130 general practitioners in Lubumbashi. Results : This study highlighted the existence of physicians who had not received training on antibiotics, those who prescribed antibiotics based on severe clinical symptoms and personal clinical experience, and others who sometimes requested additional tests before prescribing an antibiotic. Regarding situations that compelled physicians to prescribe antibiotics directly, the patient's standard of living and the cost of testing influenced physicians' decisions. Physicians are aware that antibiotic overprescription contributes to the development of bacterial resistance. Concerning the main obstacles to more rational antibiotic prescribing, the lack of diagnostic tests and the fear of complications were observed to be the major barriers. Conclusion : These results show that diagnostic uncertainty in Lubumbashi contributes to the inappropriate prescribing of antibiotics due to a lack of training on antibiotics and the factors influencing antibiotic prescribing. Therefore, implementing continuing education programs, using rapid diagnostic tests, and promoting shared decision-making with patients are effective strategies for reducing inappropriate prescriptions. Keywords: Uncertainty, Diagnosis, Prescription, Antibiotics.