Beyond clinical reasoning: survey results on how GPs’ attitudes, workload, and organizational context shape antibiotic prescribing in primary care

Objective Antibiotic prescribing in primary care is influenced by more than clinical reasoning; it is embedded in the social and organizational contexts of everyday practice. This study explores how general practitioners’ (GPs) individual characteristics – including attitudes toward antibiotic resistance, well-being, and defensive medicine – interact with organizational factors such as daily consultation volume and practice size, to shape prescribing behavior and adherence to the WHO AWaRe classification principles.Methods Data were collected through a self-selected structured online questionnaire from 302 GPs in the Czech Republic (CR).Results Findings reveal that older GPs and those with higher consultation volumes reported higher antibiotic prescribing rates and lower adherence to guidelines. GPs with prescribing behavior aligned more closely with the AWaRe principles, and who had a sense of personal responsibility for antimicrobial resistance, prescribed fewer antibiotics and performed better in clinical vignettes.Conclusion These results underscore the complex interplay between structural workload, age-related professional habits, and normative orientations in shaping antibiotic prescribing practices.