Perception of acceptable antibiotic stewardship strategies in outpatient settings

Introduction. - Antibiotics are still often inappropriately prescribed in France despite specific measures being taken for over 10 years. The 25% decrease in antibiotic prescription advocated in the 2011-2016 National Antibiotic Plan seems difficult to achieve. One of the strategies currently considered in France is the use of a specific prescription form dedicated to antibiotics, with an educational message for patients. We aimed to evaluate the acceptability by primary care prescribers of this measure and to evaluate their perception of other antibiotic stewardship strategies. Methods. - Qualitative study conducted among family physicians, pediatricians, dermatologists, dentists, and ENT specialists using semi-structured interviews. A thematic and framework analysis was then performed. Results. - Thirty prescribing physicians practicing in a specific region of France were included in the study. The dedicated prescription form for antibiotics was deemed excessive and questionable. Other measures, not directly targeting prescribers, were rather well perceived: the unit sales of antibiotics, the restricted reporting of susceptibility tests, or the limitation of the number of molecules available in outpatient settings. Conclusion. - The results of this exploratory study may guide the national antibiotic stewardship policy in France. (C) 2016 Published by Elsevier Masson SAS.