scholarly journals Evaluation of Antibiotic Prescribing Patterns in Paediatric Dental Patients: Cross - Sectional Epidemiological Study

2021 ◽  
Vol 25 (2) ◽  
pp. 122-128
Author(s):  
Tugba Yigit ◽  
Sibel Ezberci ◽  
Burcu Gucyetmez Topal
Keyword(s):  
Dental Trauma ◽  
Prescribing Patterns ◽  
Professional Experience ◽  
Antibiotic Prescribing ◽  
Negative Consequences ◽  
Cross Sectional ◽  
Oral Infections ◽  
First Choice ◽  
General Dentists ◽  
Dental Infections

Summary Background/Aim: The purpose of this study was to investigate the antibiotic prescribing patterns for the treatment of paediatric oral infection, dental trauma and prophylaxis among dentists in Turkey. Material and Methods: A total of 206 paediatric dentists, including general dentists, paediatric dentists and specialist dentists, participated in this cross-sectional study. The questionnaire included questions about the number of paediatric patients treated and antibiotics prescribed, the most commonly prescribed antibiotic for oral infections and the clinical conditions under which antibiotics were prescribed. The participants’ ages, workplaces and professional experience were also evaluated. Results: The majority of the participants were paediatric dentists (45.1%) and general dentists (42.7%). For the management of dental infections, most dentists prescribed penicillin (94.7%). Their foremost prescription choices for the presence of an anaerobic infection were metronidazole (48.5%) and penicillin (32%). For dental trauma, the most common antibiotic-prescribed cases were avulsion and contaminated wounds, followed by alveolar fracture. Antibiotics were prescribed as a first choice for dental infections and dental infections of anaerobic origin, with no significant differences between professional experience or dental specialty in the dentists (p > 0.05). Practitioners belonging to Ministry of Health dental centres significantly differed from all other groups in preferring the antibiotic cephalosporin for dental infections of anaerobic origin. Conclusions: Adherence to published guidelines for antibiotic prescriptions for anaerobic dental infections and dental trauma was low. Clearer, more specific guidelines and increased post-graduate education could lead to a reduction in the negative consequences of this issue’s resultant over-prescribed antibiotics.

scholarly journals 603. Evaluating the Effects of Centers for Medicare & Medicaid Services Sepsis Core Measure in a Community Hospital

2020 ◽  
Vol 7 (Supplement_1) ◽  
pp. S364-S364
Author(s):  
So Kim ◽  
Peter Ty
Keyword(s):  
Length Of Stay ◽  
Improve Patient Care ◽  
Prescribing Patterns ◽  
Hospital Length Of Stay ◽  
Antibiotic Prescribing ◽  
Antibiotic Administration ◽  
Negative Consequences ◽  
Treatment Standards ◽  
Core Measure ◽  
Core Measures

Abstract Background Sepsis is the leading cause of morbidity and mortality in hospitals, accounting for 30% of deaths in the emergency department. In 2001, Rivers et al. found that early goal-directed therapy (EGDT) led to significant mortality benefits, which ultimately prompted United States Centers for Medicare and Medicaid Services (CMS) to mandate EGDT in hospitals through its implementation of sepsis core measures. CMS core measures are intended to facilitate the broad implementation of evidence-based treatment standards, and while voluntary, non-compliance is associated with negative consequences to both quality and financial metrics for participating hospitals. However, while quality measures are implemented to ultimately improve patient care, its effects on the healthcare system can also include negative unanticipated consequences. This study seeks to characterize the effect of the CMS sepsis core measure on sepsis identification, antimicrobial utilization, and nd specific prescribing patterns. Methods This is a retrospective cohort review of 175 randomly selected patients greater than and equal to 18 years of age with admitting diagnosis of sepsis, severe sepsis, and septic shock from January 2013 to December 2018. Medical charts were reviewed for relevant data. Results Comparing ED antibiotic prescribing patterns between pre-and post-Sepsis CMS Core Measures, there was no statistical difference in total antibiotics usage and the initiation of broad antibiotics. There was a decreased time to the first antibiotic, an increase in receiving Normal Saline boluses post-Sepsis CMS Core Measures. Conclusion 1. No significant changes were seen in ED antibiotic prescribing behaviors with regard to volume and spectrum 2. ED time to antibiotic administration was significantly faster after the implementation of CMS Core Measures. Also, there was a significant positive shift in time to fluid bolus, fluid selection, and fluid volume 3. Significantly decreased ICU length of stay after implementation of CMS Core Measures possibly associated with above behavior changes 4. No outcomes benefits (mortality, hospital length of stay) realized after implementation of CMS Core Measures Disclosures All Authors: No reported disclosures

scholarly journals 967. Concordance of Antibiotic Prescribing with the Proposed American Dental Association Acute Oral Infection Guidelines within Veterans Affairs (VA) Dentistry

2019 ◽  
Vol 6 (Supplement_2) ◽  
pp. S31-S32
Author(s):  
Daniel Carlsen ◽  
Katie J Suda ◽  
Ursula C Patel ◽  
Gretchen Gibson ◽  
Marianne M Jurasic ◽  
...  
Keyword(s):  
Dental Treatment ◽  
Apical Periodontitis ◽  
Antibiotic Prescribing ◽  
Cross Sectional ◽  
Oral Infections ◽  
American Dental Association ◽  
Dental Procedures ◽  
Icd 10 ◽  
Future Work ◽  
Irreversible Pulpitis

Abstract Background US dentists prescribe 10% of outpatient antibiotics. However, assessing the appropriateness of dental antibiotic prescribing has been challenging due to a lack of guidelines for common infections. In 2019, the American Dental Association proposed clinical practice guidelines (CPG) on the management of common acute oral infections for the first time. Our objective was to describe national baseline antibiotic prescribing for the treatment of irreversible pulpitis, apical periodontitis, and acute apical abscess prior to the release of the proposed CPG. Methods We performed a cross-sectional analysis of national VA data from January 1, 2017 to December 31, 2017. We identified cases of irreversible pulpitis, apical periodontitis, and acute apical abscess using ICD-10-CM codes. Patient demographics, facility location, medical conditions, dental procedure codes (“CDTs”), and diagnostic (ICD-10-CM) codes were extracted from the VA Corporate Data Warehouse. Antibiotics prescribed by a dentist within 7 days of a visit were included. Multivariable logistic regression identified variables associated with antibiotic prescribing for each infection. Results Of the 470,039 VA dental visits with oral infections coded, 25% of irreversible pulpitis, 41% of apical periodontitis, and 61% of acute apical abscess visits received antibiotics. Amoxicillin was prescribed most frequently. Although the median days’ supply was 7 days, prolonged use of antibiotics was frequent (9.2% of irreversible pulpitis, 17.8% of apical periodontitis, 28.7% of acute apical abscess received antibiotics for ≥8 days). Of the irreversible pulpitis visits with antibiotics prescribed, 20.0% received ≥2 antibiotics. Patients with high-risk cardiac conditions, prosthetic joints, and certain dental procedures were associated with receipt of antibiotics (table). Conclusion Prior to the release of the ADA guidelines, 75.8% and 59.4% of irreversible pulpitis and apical periodontitis were concordant with proposed recommendations. These data identify opportunities to improve prescribing and serve as a benchmark for future outpatient antimicrobial stewardship efforts. Future work should assess definitive dental treatment and populations without access to oral health care. Disclosures All Authors: No reported Disclosures.

scholarly journals Trends and patterns of antibiotic prescribing at orthopedic inpatient departments of two private-sector hospitals in Central India: A 10-year observational study

PLoS ONE ◽  
2021 ◽  
Vol 16 (1) ◽  
pp. e0245902
Author(s):  
Kristina Skender ◽  
Vivek Singh ◽  
Cecilia Stalsby-Lundborg ◽  
Megha Sharma
Keyword(s):  
Design Patterns ◽  
Central India ◽  
Antibiotic Use ◽  
Cross Sectional Study ◽  
Prescribing Patterns ◽  
Essential Medicines ◽  
World Health ◽  
Antibiotic Prescribing ◽  
Cross Sectional ◽  
Defined Daily Doses

Background Frequent antibiotic prescribing in departments with high infection risk like orthopedics prominently contributes to the global increase of antibiotic resistance. However, few studies present antibiotic prescribing patterns and trends among orthopedic inpatients. Aim To compare and present the patterns and trends of antibiotic prescription over 10 years for orthopedic inpatients in a teaching (TH) and a non-teaching hospital (NTH) in Central India. Methods Data from orthopedic inpatients (TH-6446; NTH-4397) were collected using a prospective cross-sectional study design. Patterns were compared based on the indications and corresponding antibiotic treatments, mean Defined Daily Doses (DDD)/1000 patient-days, adherence to the National List of Essential Medicines India (NLEMI) and the World Health Organization Model List of Essential Medicines (WHOMLEM). Antibiotic prescriptions were analyzed separately for the operated and the non-operated inpatients. Linear regression was used to analyze the time trends of antibiotic prescribing; in total through DDD/1000 patient-days and by antibiotic groups. Results Third generation cephalosporins were the most prescribed antibiotic class (TH-39%; NTH-65%) and fractures were the most common indications (TH-48%; NTH-48%). Majority of the operated inpatients (TH-99%; NTH-97%) were prescribed pre-operative prophylactic antibiotics. The non-operated inpatients were also prescribed antibiotics (TH-40%; NTH-75%), although few of them had infectious diagnoses (TH-8%; NTH-14%). Adherence to the NLEMI was lower (TH-31%; NTH-34%) than adherence to the WHOMLEM (TH-65%; NTH-62%) in both hospitals. Mean DDD/1000 patient-days was 16 times higher in the TH (2658) compared to the NTH (162). Total antibiotic prescribing increased over 10 years (TH-β = 3.23; NTH-β = 1.02). Conclusion Substantial number of inpatients were prescribed antibiotics without clear infectious indications. Adherence to the NLEMI and the WHOMLEM was low in both hospitals. Antibiotic use increased in both hospitals over 10 years and was higher in the TH than in the NTH. The need for developing and implementing local antibiotic prescribing guidelines is emphasized.

scholarly journals Antimicrobial prescribing patterns in surgical inpatient of tertiary care hospital in Eastern India

2019 ◽  
Vol 8 (8) ◽  
pp. 1902
Author(s):  
Sumit Kumar Gupta ◽  
Siddhartha Ghosh
Keyword(s):  
Tertiary Care ◽  
Relevant Information ◽  
Prescribing Patterns ◽  
Antibiotic Prescribing ◽  
Antibiotic Administration ◽  
Care Hospital ◽  
Beta Lactam ◽  
Cross Sectional ◽  
Before And After ◽  
Surgery Department

Background: Antimicrobials form the cornerstone of prescriptions for treating infection. Surgical management cannot be possible without the use of antibiotics. Severity of infection, suspected spectrum of organisms and their sensitivity, co-morbidities of the patient, route of antibiotic administration are the important parameter to consider before selecting antibiotic.Methods: Cross-sectional, hospital based, descriptive study was conducted in the ward of Surgery Department of IQ City Medical college, Durgapur over a period of 1 year. The relevant information was entered into the pretested preformats (containing name, age, sex, diagnosis, ongoing treatment as recorded from patients’ prescription slips or CRFs) and analyzed. Necessary permission was granted by the Institutional Ethical Committee and written informed consent was obtained from the patients prior to collecting their prescription slips/CRF.Results: Commonest cause of hospitalization was cholelithiasis (318 (32.7%)). Antimicrobials were the most commonly prescribed drugs (1626 (31.6%)). Single antibiotic prescribing frequency are similar to two antibiotic prescribing (both 44%). Piperacillin+Tazobactum combination most commonly prescribe antibiotic.Conclusions: Beta lactam antibiotic specifically Piperacillin (ATC class: J01D) were the most commonly prescribed antibiotic agents both before and after surgical procedures.

Antibiotics Prescription Patterns among Dentists in Lahore, Pakistan

2021 ◽  
Vol 15 (10) ◽  
pp. 2656-2659
Author(s):  
Saood Khan Lodhi ◽  
Saroosh Ehsan ◽  
Malik Ali Hassan Sajid ◽  
Adeela Rafique ◽  
Mehak Fatima Khan
Keyword(s):  
Cross Sectional Survey ◽  
Cross Sectional ◽  
Prescription Pattern ◽  
Odontogenic Infections ◽  
Dental Office ◽  
Margin Of Error ◽  
Level Of Significance ◽  
General Dentists ◽  
Keywords Antibiotics ◽  
Dental Infections

Background: Odontogenic infections are one of the main causes of patients visit to a dental office. Antibiotics are magical drugs that have revolutionized the 20th Century in their ability to treat infectious diseases, increasing the life expectancy of individuals. Antibiotics prescription is a common practice among dental professionals and according to an estimate by Centre for Disease Control (CDC) and American Dental Association (ADA), over prescription of antibiotics is seen in 30-50% of the cases. Aim: To assess and compare (no comparison) the antibiotic prescription pattern among general dentists and specialty dentists in Lahore, Pakistan. Methodology: A cross sectional survey was conducted amongst dentists working in the teaching institutions and in the private clinics of Lahore. A pre-piloted questionnaire survey adopted from Jagan et al with slight modifications was used. In this descriptive study 300 practicing dentists were selected using consecutive sampling with a 5% level of significance and margin of error Results: Total 300 filled questionnaires were collected. Almost 84% of the dentists were less than 30 years old while 13% were between 31-40 years old. Of the participants 65.3% were females and 34.7 percent were males. Dental infections associated with gross swelling or associated with closure of the eye were the most common reasons for prescription of antibiotics. Almost 62% of the dentists would give antibiotic if any delay in treatment is anticipated. Almost 50% of the dentists would prescribe antibiotics for periapical abscess and cellulitis. Conclusion: There is a trend towards over prescription of antibiotics by dentists without following the standard guidelines. Emphasis on the correct prescription strategies of antibiotics at the undergraduate level and more awareness should be created as continuing dental education programs for practicing dentists. Keywords: Antibiotics, Dentists, Prescription Pattern.

scholarly journals Identifying antibiotic prescribing patterns through multi-level latent profile analyses: a cross-sectional survey of primary care physicians in Hubei of China

2020 ◽  
Author(s):  
Dan Wang ◽  
Chaojie Liu ◽  
Xinping Zhang ◽  
Chenxi Liu
Keyword(s):  
Primary Care ◽  
Broad Spectrum ◽  
Primary Care Physicians ◽  
Prescribing Patterns ◽  
Antibiotic Prescribing ◽  
Prescribing Practices ◽  
Cross Sectional Survey ◽  
Cross Sectional ◽  
Latent Profile Analyses ◽  
Broad Spectrum Antibiotics

Abstract Background Overuse of antibiotics significantly fuels the development of AMR, which threating the global population health. Great variations existed in antibiotic prescribing practices among physicians, indicating improvement potential for rational use of antibiotics. This study aims to identify antibiotic prescribing patterns of primary care physicians and potential determinants. Methods A cross-sectional survey was conducted on 551 physicians from 67 primary care facilities in Hubei selected through random cluster sampling, tapping into their knowledge, attitudes and prescribing practices toward antibiotics. Prescriptions (n=501,072) made by the participants from 1 January to 31 March 2018 were extracted from the medical records system. Seven indicators were calculated for each prescriber: average number of medicines per prescription, average number of antibiotics per prescription, percentage of prescriptions containing antibiotics, percentage of antibiotic prescriptions containing broad-spectrum antibiotics, percentage of antibiotic prescriptions containing parenteral administered antibiotics, percentage of antibiotic prescriptions containing restricted antibiotics, and percentage of antibiotic prescriptions containing antibiotics included in the WHO “Watch and Reserve” list. Two-level latent profile analyses were performed to identify the antibiotic prescribing patterns of physicians based on those indicators. Multi-nominal logistic regression models were established to identify determinants with the antibiotic prescribing patterns. Results On average, each primary care physician issued 909 (ranging from 100 to 11941 with a median of 474) prescriptions over the study period. The mean percentage of prescriptions containing antibiotics issued by the physicians reached 52.19% (SD=17.20%). Of those antibiotic prescriptions, an average of 82.29% (SD=15.83%) contained broad-spectrum antibiotics; 71.92% (SD=21.42%) contained parenteral administered antibiotics; 23.52% (SD=19.12%) contained antibiotics restricted by the regional government; and 67.74% (SD=20.98%) contained antibiotics listed in the WHO “Watch and Reserve” list. About 28.49% of the prescribers were identified as low antibiotic users, compared with 51.18% medium users and 20.33% high users. Higher use of antibiotics was associated with insufficient knowledge, indifference to changes, complacency with satisfied patients, low household income and rural location of the prescribers. Conclusion Great variation in antibiotic prescribing patterns exists among primary care physicians in Hubei of China. High use of antibiotics is not only associated with knowledge shortfalls but also low socioeconomic status of prescribers.

scholarly journals Prescribed Daily Dose (PDD) Antibiotik Untuk Penyakit Gigi di Salah Satu Apotek di Surabaya

2017 ◽  
Vol 2 (2) ◽  
pp. 20-23
Author(s):  
Ilil Maidatuz Zulfa ◽  
Fitria Dewi Yunitasari
Keyword(s):  
Clavulanic Acid ◽  
Bacterial Resistance ◽  
Periodontal Diseases ◽  
Cross Sectional Study ◽  
Prescribing Patterns ◽  
Defined Daily Dose ◽  
Cross Sectional ◽  
Hygiene Measures ◽  
Daily Dose ◽  
Dental Infections

ABSTRAKAntibiotik sistemik banyak diresepkan oleh dokter gigi baik sebagai profilaksis maupun penanganan infeksi. Tingginya peresepan antibiotik pada infeksi gigi dan periodontal akan berpotensi pada peningkatan resistensi bakteri karena penggunaan yang berlebihan. Tujuan dari penelitian ini adalah untuk menginvestigasi pola peresepan, Prescribed Daily Dose (PDD) dan rasio PDD/DDD yang ditetapkan WHO setiap antibiotik yang diresepkan untuk penyakit gigi. Studi cross-sectional retrospektif dilakukan pada rekam resep tahun 2016 di salah satu Apotek di Surabaya. Sebanyak 136 resep untuk penyakit gigi telah dianalisis dalam penelitian ini. Rata-rata usia pasien adalah 38,92+12,96 tahun. Antibiotik yang paling banyak diresepkan adalah Golongan –Laktam yaitu Amoksisilin (50,72%) dan Amoksisilin+Asam Klavulanat (3,62%) diikuti oleh golongan Linkosamid yaitu Klindamisin (28,99%) dan Linkomisin (5,80%), serta golongan Nitroimidazol yaituMetronidazol (5,07%). PDD Antibiotik yang diresepkan lebih rendah dibanding DDD yang ditetapkan WHO kecuali Amoksisilin (1509,2 mg/pasien/hari; rasio PDD/DDD 1,59), Amoksisilin+Asam Klavulanat (1368,42 mg/pasien/hari; rasio PDD/DDD 1,37), Eritromisin (1500,00 mg/pasien/hari; rasio PDD/DDD 1,50), dan Levofloksasin (500,00 mg/pasien/hari; rasio PDD/DDD 1,00). Terdapat perbedaan antara nilai PDD beberapa antibiotik dengan nilai DDD yang ditetapkan WHO dimana dalam penelitian ini nilai PDD lebih merefleksikan densitas penggunaan antibiotik.Kata kunci: Prescribed Daily Dose (PDD), Antibiotik, Infeksi gigi.ABSTRACTSistemic Antibiotics are prescribed by dentists not only for treatment of infection but also for profilactics. Most of dental and periodontal diseases are best treated by operative intervention and oral hygiene measures, so that the use of sistemic antibiotics are very limited. High rates of sistemic antibiotics prescribing in densitry can lead to bacterial resistance due to overuse of antibiotics. The aim of the study was to investigate the antibiotics prescribing patterns in densitry, Prescribed Daily Dose (PDD), and PDD/WHO’s Defined Daily Dose (DDD) ratio. A retrospective cross-sectional study was conducted on 2016 prescription records at a private pharmacy in Surabaya, East Java, Indonesia. A total 136 prescription records were analyzed. The average age of patients was 38,92+12,96 years old. The most common antibiotics prescribed in densitry was –Lactam group which were Amoxycillin (50,72%) and Amoxycillin+Clavulanic Acid (3,62%) followed by Linkosamide group w Clindamycin (28,99%) and Lincomycin (5,80%), and Nitroimidazol group which was Metronidazole (5,07%). The PDD of Antibiotics prescribed was lower than each WHO’s DDD except Amoxycillin (1509,2mg/patient/day; PDD/DDD ratio 1,59), Amoxycillin+Clavulanic Acid (1368,42 mg/patient/day; PDD/DDD ratio 1,37), Eritromisin (1500,00 mg/patient/day; PDD/DDD ratio 1,50), dan Levofloksasin (500,00 mg/patient/day; PDD/DDD ratio 1,00). There was a difference between PDD and WHO’s DDD. PDD was more likely reflect the density of antibiotic usage. Key Words: Prescribed Daily Dose (PDD), Antibiotics, Dental Infections

scholarly journals Antibiotic Prescribing Practices of Endodontic Postgraduate Trainees in Karachi, Pakistan

2021 ◽  
Vol 30 (03) ◽  
pp. 183-188
Author(s):  
Azam Muhammad Aliuddin ◽  
◽  
Sarosh Sadruddin Morani ◽  
Abubakar Sheikh ◽  
Saqib Rashid ◽  
...  
Keyword(s):  
Cross Sectional Study ◽  
Apical Periodontitis ◽  
Antibiotic Prescribing ◽  
Prescribing Practices ◽  
Duration Of Treatment ◽  
Cross Sectional ◽  
Post Graduate ◽  
Odontogenic Infections ◽  
First Choice ◽  
Graduate Trainees

OBJECTIVE: The aim of this study was to assess the knowledge of Endodontic Postgraduate trainees regarding clinically relevant situations where an antibiotic cover is needed and is focused on the prescription patterns of various antibiotics depending on the clinical evaluation of the patients. METHODOLOGY: A cross sectional study was performed in which data was collected from five different dental institutes offering post-graduate residency in endodontics all over Karachi, Pakistan. Preferred antibiotic for odontogenic infections and the duration for the antibiotic coverage were evaluated amongst postgraduate clinicians. A total of 100 questionnaires were distributed out of which only 82 questionnaires came back with responses. The study was conducted for a period of one month from August 2018- September 2018. The data collected was analyzed by SPSS version 21. RESULTS: A combination of amoxicillin with Clavulanic acid was the first choice of antibiotic in patients with no known allergies to penicillin (40.6%), whereas erythromycin was the first choice of antibiotic in patients having allergic reactions to penicillin (39.3%). The duration of treatment on average was 5 days. In clinical situations of irreversible pulpitis, with or without apical periodontitis, 74.3% and 67% of the respondents prescribed antibiotics. 78 % of respondents have prescribed antibiotics in cases of necrotic pulp with acute apical periodontitis. CONCLUSION: Our study concludes that antibiotic over prescription is very common amongst post graduate trainees and is contributing towards a larger issue of antibiotic resistance. Proper protocols of prescription should be followed by professionals and further refinement is required focusing on need, duration and choice of the antibiotic being used. KEYWORDS: Antibiotics, Odontogenic infections, Endodontics, Microbial resistance

scholarly journals Burnout among German oncologists: A cross-sectional study in cooperation with the Arbeitsgemeinschaft Internistische Onkologie Quality of Life Working Group

2021 ◽  
Author(s):  
Madeleine Helaß ◽  
Georg Martin Haag ◽  
Ulli Simone Bankstahl ◽  
Deniz Gencer ◽  
Imad Maatouk
Keyword(s):  
Quality Of Life ◽  
Working Group ◽  
Cross Sectional Study ◽  
Professional Experience ◽  
Negative Consequences ◽  
Sectional Study ◽  
Cancer Society ◽  
Cross Sectional ◽  
Increased Risk

Abstract Purpose Oncologists are at an increased risk of developing burnout, leading to negative consequences in patient care and in professional satisfaction and quality of life. This study was designed to investigate exhaustion and disengagement among German oncologists and assess the prevalence of burnout among oncologists within different professional settings. Furthermore, we wanted to examine possible relations between sociodemographic factors, the oncological setting, professional experience and different aspects of burnout. Methods In a cross-sectional study design, an Internet-based survey was conducted with 121 oncologists between April and July 2020 using the Oldenburg Burnout Inventory, which contains items on exhaustion, disengagement, and burnout. Furthermore, sociodemographic data of the participants were assessed. The participants were members of the Working Group Medical Oncology (Arbeitsgemeinschaft Internistische Onkologie) within the German Cancer Society. Results The survey showed a burnout prevalence of 43.8%, which correlated with age and professional experience; that is, the prevalence is particularly high among younger oncologists. Exhaustion is closely related to employment status; that is, it was significantly higher among employed oncologists. There were remarkably low levels of disengagement among oncologists, highlighting the own demand to fulfill job requirements despite imminent or actual overburdening in daily work. Conclusion More support is necessary to mitigate the professional stressors in the healthcare system. To ensure quality medical care, employees should be offered preventive mental health services early in their careers.

scholarly journals Influences on antibiotic prescribing by non-medical prescribers for respiratory tract infections: a systematic review using the theoretical domains framework

2020 ◽  
Vol 75 (12) ◽  
pp. 3458-3470 ◽  
Author(s):  
Angel Chater ◽  
Hannah Family ◽  
Rosemary Lim ◽  
Molly Courtenay
Keyword(s):  
Respiratory Tract ◽  
Respiratory Tract Infections ◽  
Social Influences ◽  
Public Awareness ◽  
Theoretical Domains Framework ◽  
Prescribing Patterns ◽  
Antibiotic Prescribing ◽  
Negative Consequences ◽  
Prescribing Behaviour ◽  
Tract Infections

Abstract Background The need to conserve antibiotic efficacy, through the management of respiratory tract infections (RTIs) without recourse to antibiotics, is a global priority. A key target for interventions is the antibiotic prescribing behaviour of healthcare professionals including non-medical prescribers (NMPs: nurses, pharmacists, paramedics, physiotherapists) who manage these infections. Objectives To identify what evidence exists regarding the influences on NMPs’ antimicrobial prescribing behaviour and analyse the operationalization of the identified drivers of behaviour using the Theoretical Domains Framework (TDF). Methods The search strategy was applied across six electronic bibliographic databases (eligibility criteria included: original studies; written in English and published before July 2019; non-medical prescribers as participants; and looked at influences on prescribing patterns of antibiotics for RTIs). Study characteristics, influences on appropriate antibiotic prescribing and intervention content to enhance appropriate antibiotic prescribing were independently extracted and mapped to the TDF. Results The search retrieved 490 original articles. Eight papers met the review criteria. Key issues centred around strategies for managing challenges experienced during consultations, managing patient concerns, peer support and wider public awareness of antimicrobial resistance. The two most common TDF domains highlighted as influences on prescribing behaviour, represented in all studies, were social influences and beliefs about consequences. Conclusions The core domains highlighted as influential to appropriate antibiotic prescribing should be considered when developing future interventions. Focus should be given to overcoming social influences (patients, other clinicians) and reassurance in relation to beliefs about negative consequences (missing something that could lead to a negative outcome).

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