An antimicrobial stewardship program initiative: a qualitative study on prescribing practices among hospital doctors

Antimicrobial Resistance and Infection Control

Brita Skodvin³  Karina Aase²  Esmita Charani¹  Alison Holmes¹  Ingrid Smith³ 

[1] NIHR Health Protection Research Unit in Healthcare Associated Infection and Antimicrobial Resistance, Imperial College London, Du Cane Road, London W12 0NN, UK

[2] Department of Health Studies, University of Stavanger, Stavanger, 4036, Norway

[3] Norwegian Advisory Unit on Antibiotic use in hospitals, Department of Research and Development, Haukeland University Hospital, Bergen, 5021, Norway

关键词: Qualitative research;    Antimicrobial guideline;    Antimicrobial resistance;    Hospital doctors;    Prescription practices;    Antimicrobial use;   

Others  :  1220723
DOI  :  10.1186/s13756-015-0065-4

 received in 2015-02-11, accepted in 2015-05-24,  发布年份 2015

【 摘 要 】

Background

Norway has a low, but increasing prevalence of resistance and few antimicrobial stewardship initiatives. When developing stewardship interventions, an understanding of the determinants of antimicrobial prescribing is needed. We report on the first qualitative study investigating factors influencing doctors’ antimicrobial prescribing practices in Norwegian hospitals.

Methods

Qualitative semi-structured interviews were conducted with 15 Norwegian hospital doctors prescribing antimicrobials to adult patients. Interviews were transcribed verbatim and thematic analysis was applied to analyse the data.

Results

Colleagues, in particular infectious disease specialists, microbiology test results and the newly published national guideline on antimicrobials were identified as key factors influencing antimicrobial prescribing practices. Delayed availability was a barrier for the utilization of microbiology test results and increasing clinical experience overrides the influence of the national guideline.

Patient assessment, informal training by experienced colleagues, and infectious disease specialists replacing managers in promoting prudent prescribing policies, also influenced prescribing practices.

Conclusion

This study identified the following contextual factors that need to be addressed when developing antimicrobial stewardship programs in Norway: a common work practice for seeking collegial advice, logistics of microbiology test results, and formal leadership and systematic training on prudence. Other countries initiating stewardship programmes may benefit from performing a similar mapping of facilitators and barriers, to identify important stakeholders and organisational obstacles, before developing sustainable and tailored antimicrobial stewardship interventions.

【 授权许可】

   
2015 Skodvin et al.

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