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Factors Affecting Antibiotic Prescription among Hospital Physicians in a Low-Antimicrobial-Resistance Country: A Qualitative Study

Antimicrobial resistance (AMR) is a threat to hospital patients. Antimicrobial stewardship programs (ASPs) can counteract AMR. To optimize ASPs, we need to understand what affects physicians’ antibiotic prescription from several contexts. In this study, we aimed to explore the factors affecting hosp...

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Autores principales: Christensen, Ingrid, Haug, Jon Birger, Berild, Dag, Bjørnholt, Jørgen Vildershøj, Skodvin, Brita, Jelsness-Jørgensen, Lars-Petter
Formato: Online Artículo Texto
Lenguaje:English
Publicado: MDPI 2022
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8773165/
https://www.ncbi.nlm.nih.gov/pubmed/35052975
http://dx.doi.org/10.3390/antibiotics11010098
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author Christensen, Ingrid
Haug, Jon Birger
Berild, Dag
Bjørnholt, Jørgen Vildershøj
Skodvin, Brita
Jelsness-Jørgensen, Lars-Petter
author_facet Christensen, Ingrid
Haug, Jon Birger
Berild, Dag
Bjørnholt, Jørgen Vildershøj
Skodvin, Brita
Jelsness-Jørgensen, Lars-Petter
author_sort Christensen, Ingrid
collection PubMed
description Antimicrobial resistance (AMR) is a threat to hospital patients. Antimicrobial stewardship programs (ASPs) can counteract AMR. To optimize ASPs, we need to understand what affects physicians’ antibiotic prescription from several contexts. In this study, we aimed to explore the factors affecting hospital physicians’ antibiotic choices in a low-resistance country to identify potential targets for future ASPs. We interviewed 14 physicians involved in antibiotic prescription in a Norwegian hospital. The interviews were audiotaped, transcribed verbatim, and analyzed using thematic analysis. The main factors affecting antibiotic prescription were a high work pressure, insufficient staff resources, and uncertainties regarding clinical decisions. Treatment expectations from patients and next of kin, benevolence towards the patients, suboptimal microbiological testing, and limited time for infectious disease specialists to offer advisory services also affected the antibiotic choices. Future ASP efforts should evaluate the system organization and prioritizations to address and manage potential time-pressure issues. To limit the use of broad-spectrum antibiotics, improving microbiology testing and the routines for consultations with infectious disease specialists seems beneficial. We also identified a need among the prescribing physicians for a debate on ethical antibiotic questions.
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spelling pubmed-87731652022-01-21 Factors Affecting Antibiotic Prescription among Hospital Physicians in a Low-Antimicrobial-Resistance Country: A Qualitative Study Christensen, Ingrid Haug, Jon Birger Berild, Dag Bjørnholt, Jørgen Vildershøj Skodvin, Brita Jelsness-Jørgensen, Lars-Petter Antibiotics (Basel) Article Antimicrobial resistance (AMR) is a threat to hospital patients. Antimicrobial stewardship programs (ASPs) can counteract AMR. To optimize ASPs, we need to understand what affects physicians’ antibiotic prescription from several contexts. In this study, we aimed to explore the factors affecting hospital physicians’ antibiotic choices in a low-resistance country to identify potential targets for future ASPs. We interviewed 14 physicians involved in antibiotic prescription in a Norwegian hospital. The interviews were audiotaped, transcribed verbatim, and analyzed using thematic analysis. The main factors affecting antibiotic prescription were a high work pressure, insufficient staff resources, and uncertainties regarding clinical decisions. Treatment expectations from patients and next of kin, benevolence towards the patients, suboptimal microbiological testing, and limited time for infectious disease specialists to offer advisory services also affected the antibiotic choices. Future ASP efforts should evaluate the system organization and prioritizations to address and manage potential time-pressure issues. To limit the use of broad-spectrum antibiotics, improving microbiology testing and the routines for consultations with infectious disease specialists seems beneficial. We also identified a need among the prescribing physicians for a debate on ethical antibiotic questions. MDPI 2022-01-13 /pmc/articles/PMC8773165/ /pubmed/35052975 http://dx.doi.org/10.3390/antibiotics11010098 Text en © 2022 by the authors. https://creativecommons.org/licenses/by/4.0/Licensee MDPI, Basel, Switzerland. This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution (CC BY) license (https://creativecommons.org/licenses/by/4.0/).
spellingShingle Article
Christensen, Ingrid
Haug, Jon Birger
Berild, Dag
Bjørnholt, Jørgen Vildershøj
Skodvin, Brita
Jelsness-Jørgensen, Lars-Petter
Factors Affecting Antibiotic Prescription among Hospital Physicians in a Low-Antimicrobial-Resistance Country: A Qualitative Study
title Factors Affecting Antibiotic Prescription among Hospital Physicians in a Low-Antimicrobial-Resistance Country: A Qualitative Study
title_full Factors Affecting Antibiotic Prescription among Hospital Physicians in a Low-Antimicrobial-Resistance Country: A Qualitative Study
title_fullStr Factors Affecting Antibiotic Prescription among Hospital Physicians in a Low-Antimicrobial-Resistance Country: A Qualitative Study
title_full_unstemmed Factors Affecting Antibiotic Prescription among Hospital Physicians in a Low-Antimicrobial-Resistance Country: A Qualitative Study
title_short Factors Affecting Antibiotic Prescription among Hospital Physicians in a Low-Antimicrobial-Resistance Country: A Qualitative Study
title_sort factors affecting antibiotic prescription among hospital physicians in a low-antimicrobial-resistance country: a qualitative study
topic Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8773165/
https://www.ncbi.nlm.nih.gov/pubmed/35052975
http://dx.doi.org/10.3390/antibiotics11010098
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