Martijn Sijbom

87 Determinants of inappropriate antibiotic prescription in primary care in developed countries with general practitioners as gatekeepers 3 Framework Culture of healthcare consumption Patient factors and experiences Culture of professional medicine Clinician attitudes and beliefs Practice environment The patient-clinician interaction Patients expect an antibiotic prescription Medical liability Diagnostic uncertainty Time pressure Preserving GP– patient relationships Primary care considered not responsible for development of antibiotic resistance Protecting business, Inability to effectively negotiate or explain antibiotic use Empathy for patients and risk perception about the seriousness of the illness Co-morbidity increasing age ongoing use of corticosteroids Comorbidity Received antibiotics in previous year A paying private patient versus patient with free access healthcare Guideline is noncomprehensive and does not clearly outline for a multitude of factors such as cough, sinus pain and the best course of action for all conditions the GP’s face during their consultations Limited time for an consultation Patients expect an antibiotic due to past experience and have high expectations of antibiotics Comorbidity

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