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A Qualitative Study of the Real-world Experiences of Infectious Diseases Fellows Regarding Antibiotic Stewardship

BACKGROUND: Antibiotic-resistant bacterial infections are a major threat to public health, yet improper use of antibiotics remains high. Infectious Diseases (ID) fellows play a major role in antibiotic stewardship efforts, but there is little research on how they view stewardship activities. We perf...

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Autores principales: Morgan, Jake R, Barlam, Tamar F, Drainoni, Mari-Lynn
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Oxford University Press 2018
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6159649/
https://www.ncbi.nlm.nih.gov/pubmed/30280120
http://dx.doi.org/10.1093/ofid/ofy102
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author Morgan, Jake R
Barlam, Tamar F
Drainoni, Mari-Lynn
author_facet Morgan, Jake R
Barlam, Tamar F
Drainoni, Mari-Lynn
author_sort Morgan, Jake R
collection PubMed
description BACKGROUND: Antibiotic-resistant bacterial infections are a major threat to public health, yet improper use of antibiotics remains high. Infectious Diseases (ID) fellows play a major role in antibiotic stewardship efforts, but there is little research on how they view stewardship activities. We performed a qualitative study to explore ID fellows’ experiences and perspectives regarding their antibiotic stewardship training and their role as future antibiotic stewards. METHODS: We conducted 17 in-depth interviews with ID fellows across the country. The interviews were transcribed verbatim by the study team, and we used grounded theory to generate themes from these interviews RESULTS: Fellows focused on concrete tasks of stewardship such as performing antibiotic approvals, didactic and case-based education, and interactions with other physicians and pharmacists. There was little focus on the broader public health relevance of antibiotic stewardship. Pharmacists, not ID physician leaders, were identified as fellows’ primary resource for antibiotic teaching. Several fellows suggested that stewardship programs should be led by pharmacists. CONCLUSIONS: ID fellowship training is not successfully conveying the public health importance of antibiotic stewardship or the role of ID physicians as leaders of antibiotic stewardship programs. Fellows are more focused on concrete tasks related to stewardship. ID training programs and societies should consider developing robust curricula involving fellows in the operation of the stewardship program itself, not solely in antibiotic approvals, emphasizing aspects of the program such as complex problem solving that fellows find most compelling, and emphasizing the important role these programs serve in improving public health.
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spelling pubmed-61596492018-10-02 A Qualitative Study of the Real-world Experiences of Infectious Diseases Fellows Regarding Antibiotic Stewardship Morgan, Jake R Barlam, Tamar F Drainoni, Mari-Lynn Open Forum Infect Dis Major Article BACKGROUND: Antibiotic-resistant bacterial infections are a major threat to public health, yet improper use of antibiotics remains high. Infectious Diseases (ID) fellows play a major role in antibiotic stewardship efforts, but there is little research on how they view stewardship activities. We performed a qualitative study to explore ID fellows’ experiences and perspectives regarding their antibiotic stewardship training and their role as future antibiotic stewards. METHODS: We conducted 17 in-depth interviews with ID fellows across the country. The interviews were transcribed verbatim by the study team, and we used grounded theory to generate themes from these interviews RESULTS: Fellows focused on concrete tasks of stewardship such as performing antibiotic approvals, didactic and case-based education, and interactions with other physicians and pharmacists. There was little focus on the broader public health relevance of antibiotic stewardship. Pharmacists, not ID physician leaders, were identified as fellows’ primary resource for antibiotic teaching. Several fellows suggested that stewardship programs should be led by pharmacists. CONCLUSIONS: ID fellowship training is not successfully conveying the public health importance of antibiotic stewardship or the role of ID physicians as leaders of antibiotic stewardship programs. Fellows are more focused on concrete tasks related to stewardship. ID training programs and societies should consider developing robust curricula involving fellows in the operation of the stewardship program itself, not solely in antibiotic approvals, emphasizing aspects of the program such as complex problem solving that fellows find most compelling, and emphasizing the important role these programs serve in improving public health. Oxford University Press 2018-05-03 /pmc/articles/PMC6159649/ /pubmed/30280120 http://dx.doi.org/10.1093/ofid/ofy102 Text en © The Author(s) 2018. Published by Oxford University Press on behalf of Infectious Diseases Society of America. http://creativecommons.org/licenses/by-nc-nd/4.0/ This is an Open Access article distributed under the terms of the Creative Commons Attribution-NonCommercial-NoDerivs licence (http://creativecommons.org/licenses/by-nc-nd/4.0/), which permits non-commercial reproduction and distribution of the work, in any medium, provided the original work is not altered or transformed in any way, and that the work is properly cited. For commercial re-use, please contact journals.permissions@oup.com
spellingShingle Major Article
Morgan, Jake R
Barlam, Tamar F
Drainoni, Mari-Lynn
A Qualitative Study of the Real-world Experiences of Infectious Diseases Fellows Regarding Antibiotic Stewardship
title A Qualitative Study of the Real-world Experiences of Infectious Diseases Fellows Regarding Antibiotic Stewardship
title_full A Qualitative Study of the Real-world Experiences of Infectious Diseases Fellows Regarding Antibiotic Stewardship
title_fullStr A Qualitative Study of the Real-world Experiences of Infectious Diseases Fellows Regarding Antibiotic Stewardship
title_full_unstemmed A Qualitative Study of the Real-world Experiences of Infectious Diseases Fellows Regarding Antibiotic Stewardship
title_short A Qualitative Study of the Real-world Experiences of Infectious Diseases Fellows Regarding Antibiotic Stewardship
title_sort qualitative study of the real-world experiences of infectious diseases fellows regarding antibiotic stewardship
topic Major Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6159649/
https://www.ncbi.nlm.nih.gov/pubmed/30280120
http://dx.doi.org/10.1093/ofid/ofy102
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