Personal beliefs and misconceptions, not evidence guide general practitioners in the managing of travelers’ diarrhea: Results from a pilot study (North-Western Italy, 2019)

Background: The present study aims to characterize knowledge, attitudes and practices in a sample of general practitioners (GPs) on management of travelers’ diarrhea (TD). Methods: A total of 158 GPs (44.3% males; mean age 40.2 ± 12.4 years) completed a web questionnaire on antibiotic prophylaxis (AP) and/or an antibiotic treatment (AT) in TD cases. Participants were inquired on knowledge status (KS), risk perception and effectively applied recommendations for AP/AT through a specifically designed questionnaire. Multivariate odds ratios (OR) for predictors of AP/AT were calculated through regression analysis. Results: All in all, while 15 (9.5%) participants recommended AP for TD, 61 of them (39.4%) recommended AT. KS was largely unsatisfying as participants extensively ignored the most recent AP/AT recommendations. Acknowledgment of TD as a severe disorder was predictive for recommendation of AP (OR 37.843, 95% CI 4.752–301.4). As for AT, it was relatively elevated in GPs ≥ 10 years (OR 2.653, 95% CI 1.169–6.019), but more rarely reported in participants with higher KS (OR 0.056, 95% CI 0.021–0.153). Conclusions: Adherence of GPs to official recommendations for TD management was unsatisfying, particularly in older participants. Continuous Education of GPs should be improved by sharing up-to-date official recommendations on AT/AP for TD.