Factors Affecting Decision-Making on Antibiotic Use for Upper Respiratory Infections Among General Practitioners and Patients in the Northern Dutch-German Border Area: A Qualitative Analysis

By
Vaitiare Mulderij-Jansen
Aida Bedri
Till Herdeg
Mieke Andre
Luuk Holterman
Marit Boer
Michael H. Freitag
Adriana Tami
Nienke Beerlage-de Jong
March 2, 2026
0 min

Bmc Primary Care

Overview

This qualitative study explores the factors influencing antibiotic prescribing decisions for upper respiratory infections (URIs) among general practitioners (GPs) and patients in the northern Dutch-German border area. It highlights the complexities of decision-making processes and the need for improved communication between GPs and patients to combat antimicrobial resistance.

Background

Antimicrobial resistance is a significant global health threat, with an estimated 700,000 deaths annually due to resistant infections. The inappropriate use of antibiotics, particularly for viral infections like URIs, exacerbates this issue. Understanding the decision-making processes of GPs and patients in prescribing antibiotics is crucial for developing effective strategies to reduce unnecessary prescriptions and mitigate resistance.

Data Highlights

This study involved semi-structured interviews with 20 GPs and 21 patients in the Ems-Dollart region, focusing on their experiences and contexts regarding antibiotic prescriptions.

Key Findings

Antibiotics are often overprescribed for URIs, despite most being viral in nature.
46% of antibiotics prescribed for respiratory infections in the Netherlands deviate from national guidelines.
GPs may prescribe antibiotics under perceived patient pressure or expectations.
Miscommunication between GPs and patients regarding expectations can lead to inappropriate prescribing.
Understanding cultural differences in antibiotic prescribing can enhance antimicrobial resistance management strategies.

Clinical Implications

Healthcare providers should prioritize effective communication with patients regarding the appropriateness of antibiotic use for URIs. Strategies to align patient expectations with clinical guidelines may help reduce unnecessary prescriptions and combat antimicrobial resistance.

Conclusion

This study underscores the importance of understanding the decision-making processes of both GPs and patients in antibiotic prescribing. Enhanced communication and cultural awareness are essential for improving antibiotic stewardship in cross-border regions.