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81. Physicians’ Knowledge, Attitude, and Practice regarding Prolonged Antimicrobial Use

BACKGROUND: To reduce unnecessary long-term antibiotic therapies, pharmacist-led intervention followed by the involvement of infectious diseases (ID) specialist was implemented. In addition, a survey for the prescribers was conducted to find the gaps for improvement. METHODS: The “less is better” in...

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Autores principales: Kim, Da Young, kim, Dahye, Heo, Eunjeong, kim, Hyung-sook, Park, Ji Young, lee, Hyunju, Seo, Jun-won, Jung, Jongtak, Moon, Song Mi, Song, Kyoung-Ho, Kim, Eu Suk, Kim, Hong Bin
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Oxford University Press 2020
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7777133/
http://dx.doi.org/10.1093/ofid/ofaa439.126
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author Kim, Da Young
kim, Dahye
Heo, Eunjeong
kim, Hyung-sook
Park, Ji Young
lee, Hyunju
Seo, Jun-won
Jung, Jongtak
Moon, Song Mi
Song, Kyoung-Ho
Kim, Eu Suk
Kim, Hong Bin
author_facet Kim, Da Young
kim, Dahye
Heo, Eunjeong
kim, Hyung-sook
Park, Ji Young
lee, Hyunju
Seo, Jun-won
Jung, Jongtak
Moon, Song Mi
Song, Kyoung-Ho
Kim, Eu Suk
Kim, Hong Bin
author_sort Kim, Da Young
collection PubMed
description BACKGROUND: To reduce unnecessary long-term antibiotic therapies, pharmacist-led intervention followed by the involvement of infectious diseases (ID) specialist was implemented. In addition, a survey for the prescribers was conducted to find the gaps for improvement. METHODS: The “less is better” intervention was implemented between August 1, 2018 and February 28, 2019, which was focused on those to whom antibiotics had been administered for over 15 days. However, the following patients were excluded: patients having hematologic diseases, patients in the neonatal intensive care units, and patients who were recommended to maintain antibiotics by ID specialist. Treatment duration according to the indications was compared between pre-intervention period (Aug to Sep 2017) and post-intervention period. A questionnaire based on clinical vignettes was distributed among 140 prescribers. RESULTS: Among 500 prescriptions assessed as a prolonged treatment, 475 (95%) were stopped after intervention. Over the pre- and post-intervention period, pneumonia was the most common indication of prolonged antibiotic use (43.8 versus 43.0%). The treatment durations decreased from 21.0 (interquartile range [IQR], 27.3-18.0) days pre-intervention to 16.0 (IQR, 20.0-15.0) days post-intervention (p=0.000). The survey response rate was 76.4% (107/140). Regarding community-acquired pneumonia, there was a significant difference between knowledge and practice, showing that 53% were aware of the standard duration, but 72% actually prescribed for a longer duration. There was a similar trend for the treatment of urinary tract infection (30% versus 83%, p=0.024). The reasons why the physicians prescribed antibiotics of a prolonged duration in spite of adequate knowledge were not only the lack of symptom alleviation in patients but also organizational factors. CONCLUSION: The duration of long-term antibiotic treatment was shortened by active participation of pharmacist as well as ID specialists. However, gaps between the knowledge and practice on the duration of antibiotic treatment were also found. Therefore, it is necessary to implement appropriate feedback and education based on clinical scenario in order to improve the physicians’ antibiotic prescription. DISCLOSURES: All Authors: No reported disclosures
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spelling pubmed-77771332021-01-07 81. Physicians’ Knowledge, Attitude, and Practice regarding Prolonged Antimicrobial Use Kim, Da Young kim, Dahye Heo, Eunjeong kim, Hyung-sook Park, Ji Young lee, Hyunju Seo, Jun-won Jung, Jongtak Moon, Song Mi Song, Kyoung-Ho Kim, Eu Suk Kim, Hong Bin Open Forum Infect Dis Poster Abstracts BACKGROUND: To reduce unnecessary long-term antibiotic therapies, pharmacist-led intervention followed by the involvement of infectious diseases (ID) specialist was implemented. In addition, a survey for the prescribers was conducted to find the gaps for improvement. METHODS: The “less is better” intervention was implemented between August 1, 2018 and February 28, 2019, which was focused on those to whom antibiotics had been administered for over 15 days. However, the following patients were excluded: patients having hematologic diseases, patients in the neonatal intensive care units, and patients who were recommended to maintain antibiotics by ID specialist. Treatment duration according to the indications was compared between pre-intervention period (Aug to Sep 2017) and post-intervention period. A questionnaire based on clinical vignettes was distributed among 140 prescribers. RESULTS: Among 500 prescriptions assessed as a prolonged treatment, 475 (95%) were stopped after intervention. Over the pre- and post-intervention period, pneumonia was the most common indication of prolonged antibiotic use (43.8 versus 43.0%). The treatment durations decreased from 21.0 (interquartile range [IQR], 27.3-18.0) days pre-intervention to 16.0 (IQR, 20.0-15.0) days post-intervention (p=0.000). The survey response rate was 76.4% (107/140). Regarding community-acquired pneumonia, there was a significant difference between knowledge and practice, showing that 53% were aware of the standard duration, but 72% actually prescribed for a longer duration. There was a similar trend for the treatment of urinary tract infection (30% versus 83%, p=0.024). The reasons why the physicians prescribed antibiotics of a prolonged duration in spite of adequate knowledge were not only the lack of symptom alleviation in patients but also organizational factors. CONCLUSION: The duration of long-term antibiotic treatment was shortened by active participation of pharmacist as well as ID specialists. However, gaps between the knowledge and practice on the duration of antibiotic treatment were also found. Therefore, it is necessary to implement appropriate feedback and education based on clinical scenario in order to improve the physicians’ antibiotic prescription. DISCLOSURES: All Authors: No reported disclosures Oxford University Press 2020-12-31 /pmc/articles/PMC7777133/ http://dx.doi.org/10.1093/ofid/ofaa439.126 Text en © The Author 2020. 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 Poster Abstracts
Kim, Da Young
kim, Dahye
Heo, Eunjeong
kim, Hyung-sook
Park, Ji Young
lee, Hyunju
Seo, Jun-won
Jung, Jongtak
Moon, Song Mi
Song, Kyoung-Ho
Kim, Eu Suk
Kim, Hong Bin
81. Physicians’ Knowledge, Attitude, and Practice regarding Prolonged Antimicrobial Use
title 81. Physicians’ Knowledge, Attitude, and Practice regarding Prolonged Antimicrobial Use
title_full 81. Physicians’ Knowledge, Attitude, and Practice regarding Prolonged Antimicrobial Use
title_fullStr 81. Physicians’ Knowledge, Attitude, and Practice regarding Prolonged Antimicrobial Use
title_full_unstemmed 81. Physicians’ Knowledge, Attitude, and Practice regarding Prolonged Antimicrobial Use
title_short 81. Physicians’ Knowledge, Attitude, and Practice regarding Prolonged Antimicrobial Use
title_sort 81. physicians’ knowledge, attitude, and practice regarding prolonged antimicrobial use
topic Poster Abstracts
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7777133/
http://dx.doi.org/10.1093/ofid/ofaa439.126
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