Failure to implement hospital antimicrobial prescribing guidelines: a comparison of two UK academic centres

The Journal of Antimicrobial Chemotherapy
M H AliS R J Maxwell

Abstract

Rational antimicrobial therapy should provide maximum benefit to patients while minimizing the development of resistant microorganisms. The aim of this study was to investigate (i) which antimicrobial drugs were chosen by hospital doctors faced with two common infections [community-acquired pneumonia (CAP) and urinary tract infection (UTI)], (ii) whether these choices were compliant with local guidance and (iii) the factors that influenced antimicrobial choice. A questionnaire based on two hypothetical clinical scenarios was distributed to 316 hospital doctors across four UK NHS hospitals in two cities (Newcastle and Edinburgh). Doctors in Newcastle were significantly more aggressive in their management: more patients were admitted (CAP: 78.9% versus 48.4%, P < 0.05) and given antimicrobials intravenously (CAP: 53.4% versus 21.2%, P < 0.05). Adherence to the local hospital guideline for CAP was significantly higher in Newcastle (83.3% versus 38.0%; P < 0.05). Fewer than half of the doctors surveyed used the local hospital guideline when choosing an antimicrobial, and the British National Formulary was the most frequently used resource (>90%). Junior doctors also identified medical school teaching and opinions of senior doctors ...Continue Reading

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Citations

Nov 8, 2008·The Journal of Antimicrobial Chemotherapy·Susan J Dawson
Nov 11, 2009·The Journal of Antimicrobial Chemotherapy·M SundqvistG Kahlmeter
Mar 12, 2011·The Journal of Antimicrobial Chemotherapy·Jean-Christophe LucetPhilippe Ravaud
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Sep 2, 2017·The Journal of Antimicrobial Chemotherapy·Chrysanthi PapoutsiGeoff Wong

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