Study title

The objectives of the online survey were to: Quantify the relative importance of clinical, social and economic factors influencing primary care providers’ prescription of antibiotics for the treatment of childhood and adult upper respiratory tract infections; Evaluate primary care providers’ knowledge about the diagnosis and management of upper respiratory tract infections; and Evaluate primary care providers’ knowledge about antibiotic resistance. The online survey was sent to a sample of nearly 4,000 South African doctors, and 433 responded to the survey.Because it increases the morbidity and mortality of bacterial infection, as well as the duration and cost of antibacterial treatment, antibiotic resistance constitutes a significant threat to global public health. The problem is even more critical in low- and middle-income countries which have higher infectious disease burdens, often higher rates of antibiotic resistance, less access to diagnostic tools, and fewer financial resources to purchase newer more effective antibiotics. In South Africa, antibiotic resistance is particularly high, despite an effective drug regulatory system and various initiatives to tackle the problem. Antibiotic resistance is accelerated by the overuse and over-prescription of antibiotics, which is the product of complex interactions between providers' decisions and knowledge, and patients' expectations. Yet research on the determinants of prescribing behaviours from LMICs in general, and South Africa in particular, is limited, and has been criticised for being too descriptive and superficial, with limited insight into the relative importance of different behavioural determinants to be able to prioritise interventions. In South Africa, most research efforts have focused on hospitals rather than primary care, despite the fact the majority of antibiotics are prescribed in primary care, mostly for respiratory infections. This study aims to explore how the interactions between providers...