Observational studyInfection control and hospital epidemiology2014
Multisite exploration of clinical decision making for antibiotic use by emergency medicine providers using quantitative and qualitative methods.
Observational study in Infection control and hospital epidemiology, 2014. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 59 papers, 3 of them syntheses that pooled it.
What it found
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The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.
Who cites it
59 citing papers in PubMed, 3 syntheses or guidelines pooled it, 127 citations in OpenAlex.
- Factors influencing physicians' antimicrobial prescribing decisions: A systematic review of qualitative studies.British journal of clinical pharmacology · 2025Pooled it
- Communication interventions to promote the public's awareness of antibiotics: a systematic review.BMC public health · 2019Pooled it
- Interventions to reduce inappropriate prescribing of antibiotics for acute respiratory tract infections: summary and update of a systematic review.The Journal of international medical research · 2018Pooled it
- Antibiotic clinical decision support for pneumonia in the ED: A randomized trial.Journal of hospital medicine · 2023Trial
- Let's Talk About Antibiotics: a randomised trial of two interventions to reduce antibiotic misuse.BMJ open · 2022Trial
- The Effect of Expert Feedback on Antibiotic Prescribing in Pediatrics: Experimental Evidence.Medical decision making : an international journal of the Society for Medical Decision Making · 2019Trial
- A Multifaceted Intervention Improves Prescribing for Acute Respiratory Infection for Adults and Children in Emergency Department and Urgent Care Settings.Academic emergency medicine : official journal of the Society for Academic Emergency Medicine · 2019Trial
- A Randomized Clinical Trial Comparing Use of Rapid Molecular Testing for Staphylococcus aureus for Patients With Cutaneous Abscesses in the Emergency Department With Standard of Care.Infection control and hospital epidemiology · 2015Trial
- Making Antibiotic Guidance Work in the Emergency Department.Infection & chemotherapy · 2026Article
- Emergency Department Clinicians' Needs for User-Centered Antibiotic Guideline: Insights from a Focus Group Interview.Infection & chemotherapy · 2026Article
- Feeling the Vibes: An Investigation Into Resident Antibiotic Prescribing Practices.Open forum infectious diseases · 2026Article
- Impact of an Educational Leaflet About Asymptomatic Bacteriuria and Urinary Tract Infection on Antibiotic Preferences Among US Adults ≥65 Years: An Online Randomized Controlled Survey Experiment.Open forum infectious diseases · 2025Article
- A Diagnostic Stewardship Success: Implementing a Urine Culture Reflex Policy in the Emergency Department of a Large Safety-Net Hospital.Open forum infectious diseases · 2025Article
- Antibiotic use and class absenteeism in children with influenza-like-illness in an emergency department.Pediatric research · 2025Article
- Provider perspectives on empirical antibiotic treatment for tuberculosis-like symptoms in South Africa's private general practice sector: A qualitative study in two cities.PLOS global public health · 2025Article
- Emergency medicine pharmacists' interventions in the tertiary hospitals' emergency departments in Malaysia.Journal of pharmaceutical policy and practice · 2025Article
- Antimicrobial prescribing quality in Australian emergency departments: an analysis of the Hospital NAPS data set.Antimicrobial stewardship & healthcare epidemiology : ASHE · 2025Article
- Determinants of appropriate antibiotic and NSAID prescribing in unscheduled outpatient settings in the veterans health administration.BMC health services research · 2024Article
- Shifting the antibiotic rhetoric in children from 'just in case' to 'disclose the risk': Has the time come?Journal of the Association of Medical Microbiology and Infectious Disease Canada = Journal officiel de l'Association pour la microbiologie medicale et l'infectiologie Canada · 2024Article
- The impact of a non-restrictive Antimicrobial Stewardship Program in the emergency department of a secondary-level Italian hospital.Internal and emergency medicine · 2024Article
Corrections and comments
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Authors and funding
12 authors at 4 institutions in 1 country.
Funding
Abstract
objectivesTo explore current practices and decision making regarding antimicrobial prescribing among emergency department (ED) clinical providers.
methodsWe conducted a survey of ED providers recruited from 8 sites in 3 cities. Using purposeful sampling, we then recruited 21 providers for in-depth interviews. Additionally, we observed 10 patient-provider interactions at one of the ED sites. SAS 9.3 was used for descriptive and predictive statistics. Interviews were audio recorded, transcribed, and analyzed using a thematic, constructivist approach with consensus coding using NVivo 10.0. Field and interview notes collected during the observational study were aligned with themes identified through individual interviews.
resultsOf 150 survey respondents, 76% agreed or strongly agreed that antibiotics are overused in the ED, while half believed they personally did not overprescribe. Eighty-nine percent used a smartphone or tablet in the ED for antibiotic prescribing decisions. Several significant differences were found between attending and resident physicians. Interview analysis identified 42 codes aggregated into the following themes: (1) resource and environmental factors that affect care; (2) access to and quality of care received outside of the ED consult; (3) patient-provider relationships; (4) clinical inertia; and (5) local knowledge generation. The observational study revealed limited patient understanding of antibiotic use. Providers relied heavily upon diagnostics and provided limited education to patients. Most patients denied a priori expectations of being prescribed antibiotics.
conclusionsPatient, provider, and healthcare system factors should be considered when designing interventions to improve antimicrobial stewardship in the ED setting.
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Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.