Table 2 Multivariable analysis of factors associated with high antibiotic prescribing rate for upper respiratory tract infection patients
Model variables | Adjusted model | ||
|---|---|---|---|
Adjusted OR (95% CI) | P-value | VIF | |
COVID-19 status (pre-DORSCON Orange) | 2.12 (1.32, 3.41) | 0.002* | 1.08 |
Attitude-related factors and Likert items | |||
Factor 1: Perception of antibiotic over-prescribing in the ED | 1.19 (0.92, 1.54) | 0.184 | 1.297 |
Likert item C1: I am confident of my antibiotic prescribing decisions for patients with URTI | 0.70 (0.47, 1.03) | 0.067 | 1.216 |
Likert item C2: Patients should take antibiotics for URTI because the risks (e.g., drug allergy, side effects etc.) are low | 2.08 (1.39, 3.11) | < 0.001** | 1.283 |
Likert item C3: Patients attending this ED are demanding about their treatment (including requesting for antibiotics for URTI) | 1.44 (1.09, 1.89) | 0.01* | 1.246 |
Likert item C13: Educating the public on appropriate antibiotic use will reduce my work pressure in handling URTI patients | 1.46 (1.05, 2.02) | 0.025* | 1.117 |
Behaviour-related factors and Likert items | |||
Factor 1: Pressure to prescribe antibiotics (pre-COVID-19) | 1.74 (1.12, 2.71) | 0.014* | 4.207 |
Factor 1: Pressure to prescribe antibiotics (post-COVID-19) | 0.99 (0.70, 1.41) | 0.973 | |
Factor 1 interaction (Factor 1 * COVID-19) | 0.57 (0.34, 0.95) | 0.030* | 3.217 |
Factor 2: Effort to prescribe antibiotics prudently due to concerns about antibiotic resistance (pre-COVID-19) | 1.10 (0.73, 1.66) | 0.645 | 3.421 |
Factor 2: Effort to prescribe antibiotics prudently due to concerns about antibiotic resistance (post-COVID-19) | 0.65 (0.46, 0.92) | 0.015* | |
Factor 2 interaction (Factor 2 * COVID-19) | 0.59 (0.35, 0.99) | 0.046* | 3.121 |
Factor 3: Lowered threshold for antibiotics prescribing | 1.83 (1.37, 2.42) | < 0.001** | 1.35 |
Likert item D16: I will prescribe antibiotics for URTI patients to keep on standby, in case they need them later (e.g., travelling to another country, condition deteriorates) | 1.25 (0.95, 1.64) | 0.109 | 1.329 |
Likert item D22: I will prescribe antibiotics for URTI patients, if they have waited a long time for medical consultation | 0.90 (0.50, 1.60) | 0.708 | 1.699 |
Likert item D27: I will discuss with the senior doctors in the department, if I am uncertain about the management of an URTI patient | 0.97 (0.79, 1.19) | 0.743 | 1.087 |