Evidence map›Paper›PMID 26075065›Full record

ArticleAntimicrobial resistance and infection control2015

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

Brita Skodvin, Karina Aase, Esmita Charani, Alison Holmes, Ingrid Smith

Open access · goldAbstract read
PubMed Full text at PMC Publisher
In one paragraph

Article in Antimicrobial resistance and infection control, 2015. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 36 papers, 2 of them syntheses that pooled it.

0numbers the graph read from it
0cells of the map it votes in
36citing papers in PubMed, 2 pooled it
4.1field-weighted citation impact, top 6% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

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.

2 · The registry

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.

3 · Its place in the literature

Who cites it

36 citing papers in PubMed, 2 syntheses or guidelines pooled it, 72 citations in OpenAlex.

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4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

5 authors at 3 institutions in 2 countries.

Brita SkodvinNorwegian Advisory Unit on Antibiotic use in hospitals, Department of Research and Development, Haukeland University Hospital, 5021 Bergen, Norway.
Karina AaseDepartment of Health Studies, University of Stavanger, 4036 Stavanger, Norway.
Esmita CharaniNIHR Health Protection Research Unit in Healthcare Associated Infection and Antimicrobial Resistance, Imperial College London, Du Cane Road, London, W12 0NN UK.
Alison HolmesNIHR Health Protection Research Unit in Healthcare Associated Infection and Antimicrobial Resistance, Imperial College London, Du Cane Road, London, W12 0NN UK.
Ingrid SmithNorwegian Advisory Unit on Antibiotic use in hospitals, Department of Research and Development, Haukeland University Hospital, 5021 Bergen, Norway.
Haukeland University Hospital · NOImperial College London · GBUniversity of Stavanger · NO

Funding

Medical Research Council G0800777
6 · The paper itself

Abstract

backgroundNorway 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.

methodsQualitative 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.

resultsColleagues, 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.

conclusionThis 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.

Indexed as

Antimicrobial guidelineAntimicrobial resistanceAntimicrobial useHospital doctorsPrescription practicesQualitative research

Identifiers

PMID26075065
PMCPMC4465159
OpenAlexW1584840487

What OpenQuestion holds

Textmetadata
LicenceCC BY
Read underepoch 390

Registered trials

None linked

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.