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Influence of antimicrobial susceptibility reporting on junior doctors' decision to prescribe antimicrobials inappropriately.
Papanicolas, Lito E; Nelson, Renjy; Warner, Morgyn S.
Afiliación
  • Papanicolas LE; Department of Infectious Diseases, The Queen Elizabeth Hospital, Level 2C, 28 Woodville Road, Woodville, South Australia 5011, Australia.
  • Nelson R; Department of Infectious Diseases, The Queen Elizabeth Hospital, Level 2C, 28 Woodville Road, Woodville, South Australia 5011, Australia.
  • Warner MS; Department of Infectious Diseases, The Queen Elizabeth Hospital, Level 2C, 28 Woodville Road, Woodville, South Australia 5011, Australia.
J Antimicrob Chemother ; 72(4): 1202-1205, 2017 04 01.
Article en En | MEDLINE | ID: mdl-27999044
Objectives: Inappropriate antimicrobial use drives antimicrobial resistance and is a global public health problem. This study examined whether withholding antimicrobial susceptibilities in combination with interpretive comments on microbiological reports influenced the decision to inappropriately prescribe antibiotics in a controlled survey. Methods: Seventy junior doctors attending educational sessions were given one of two surveys describing four clinical case vignettes (scenarios) in which antimicrobial treatment was not indicated. They were asked to select their preferred treatment from multiple choices. In the scenarios labelled 'A', the laboratory report did not report antibiotic susceptibilities, but included comments from the microbiologist. In the scenarios labelled 'B', the laboratory report included full organism identification and susceptibility results without additional comments. Results: For scenarios 1, 2 and 3 there was a significantly higher probability ( P < 0.01) that the doctor selected an answer involving antibiotic treatment if he/she received the 'B' version of the scenario where reports included antimicrobial susceptibilities, but no interpretive comments. This was significant in both interns and more senior doctors. In scenario 4, of which there were two versions, there was no difference seen in the answers between the groups given scenario A or B. Conclusions: The results of this survey suggest that withholding antimicrobial susceptibility results in combination with interpretive comments on microbiology reports significantly influences the decision of junior doctors to prescribe antibiotics in low-acuity outpatient setting scenarios (represented in scenarios 1-3), but not in inpatient scenarios (represented in scenario 4).
Asunto(s)

Texto completo: 1 Colección: 01-internacional Base de datos: MEDLINE Asunto principal: Prescripciones de Medicamentos / Pautas de la Práctica en Medicina / Prescripción Inadecuada / Cuerpo Médico de Hospitales / Antiinfecciosos Tipo de estudio: Prognostic_studies Límite: Female / Humans / Male Idioma: En Revista: J Antimicrob Chemother Año: 2017 Tipo del documento: Article País de afiliación: Australia Pais de publicación: Reino Unido

Texto completo: 1 Colección: 01-internacional Base de datos: MEDLINE Asunto principal: Prescripciones de Medicamentos / Pautas de la Práctica en Medicina / Prescripción Inadecuada / Cuerpo Médico de Hospitales / Antiinfecciosos Tipo de estudio: Prognostic_studies Límite: Female / Humans / Male Idioma: En Revista: J Antimicrob Chemother Año: 2017 Tipo del documento: Article País de afiliación: Australia Pais de publicación: Reino Unido