ArticleJournal of hospital medicine2016
Barriers to guideline-concordant antibiotic use among inpatient physicians: A case vignette qualitative study.
Article in Journal of hospital medicine, 2016. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 16 papers.
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Who cites it
16 citing papers in PubMed.
- Changes in perceptions of antibiotic stewardship among neonatal intensive care unit providers over the course of a learning collaborative: a prospective, multisite, mixed-methods evaluation.Journal of perinatology : official journal of the California Perinatal Association · 2024Article
- Vancomycin prescribing and therapeutic drug monitoring: Challenges of real clinical practice.PloS one · 2023Article
- Appropriateness of antibiotic treatment of acute respiratory tract infections in Tunisian primary care and emergency departments: a multicenter cross-sectional study.BMC primary care · 2022Article
- Understanding the complexities of antibiotic prescribing behaviour in acute hospitals: a systematic review and meta-ethnography.Archives of public health = Archives belges de sante publique · 2021Article
- Examining the Effect of Context, Beliefs, and Values on UK Farm Veterinarians' Antimicrobial Prescribing: A Randomized Experimental Vignette and Cross-Sectional Survey.Antibiotics (Basel, Switzerland) · 2021Article
- A decision algorithm to promote outpatient antimicrobial stewardship for uncomplicated urinary tract infection.Science translational medicine · 2020Article
- Why do we overtreat children with immune thrombocytopenia despite existing evidence-based guidelines?Blood transfusion = Trasfusione del sangue · 2020Article
- Putting the Dissemination and Implementation in Infectious Diseases.Clinical infectious diseases : an official publication of the Infectious Diseases Society of America · 2020Article
- Understanding the Context of High- and Low-Testosterone Prescribing Facilities in the Veterans Health Administration (VHA): a Qualitative Study.Journal of general internal medicine · 2019Article
- Intervention planning for Antibiotic Review Kit (ARK): a digital and behavioural intervention to safely review and reduce antibiotic prescriptions in acute and general medicine.The Journal of antimicrobial chemotherapy · 2019Article
- Duration of antibiotic treatment for common infections in English primary care: cross sectional analysis and comparison with guidelines.BMJ (Clinical research ed.) · 2019Article
- Assessment of Guideline Discordance With Antimicrobial Prophylaxis Best Practices for Common Urologic Procedures.JAMA network open · 2018Article
- Potential Cost-Savings with Once-Daily Aminomethylcycline Antibiotic versus Vancomycin in Hospitalized Patients with Acute Bacterial Skin and Skin Structure Infections.American health & drug benefits · 2018Article
- Barriers and facilitators of appropriate vancomycin use: prescribing context is key.European journal of clinical pharmacology · 2018Article
- Article
- Antimicrobial stewardship programs; a two-part narrative review of step-wise design and issues of controversy Part I: step-wise design of an antimicrobial stewardship program.Therapeutic advances in infectious diseaseReview
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Authors and funding
5 authors.
Funding
Abstract
backgroundGreater adherence to antibiotic-prescribing guidelines may promote more judicious antibiotic use, which could benefit individual patients and society at large.
objectiveTo assess physician knowledge and acceptance of antibiotic-prescribing guidelines through the use of case vignettes.
designWe conducted semistructured interviews with 30 inpatient physicians. Participants were asked to respond to 3 hypothetical case vignettes: (1) a skin and soft tissue infection (SSTI), (2) suspected hospital-acquired pneumonia (HAP), and (3) asymptomatic bacteriuria (ASB). All participants received feedback according to guidelines from the Infectious Diseases Society of America (IDSA) and were asked to discuss their level of comfort with following these guidelines.
settingTwo acute care teaching hospitals for adult patients.
interventionNone. MEASUREMENTS: Data from transcribed interviews were analyzed using emergent thematic analysis.
resultsParticipants were receptive to guidelines and believed they were useful. However, participants' responses to the case vignettes demonstrated that IDSA guideline recommendations were not routinely followed for SSTI, HAP, and ASB. We identified 3 barriers to guideline-concordant care: (1) physicians' lack of awareness of specific guideline recommendations; (2) tension between adhering to guidelines and the desire to individualize patient care; and (3) skepticism of certain guideline recommendations.
conclusionsCase vignettes may be useful tools to assess physician knowledge and acceptance of antibiotic-prescribing guidelines. Using case vignettes, we identified 3 barriers to following IDSA guidelines. Efforts to improve guideline-concordant antibiotic prescribing should focus on reducing such barriers at the local level.
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