Professional and psychosocial factors can significantly influence a physician's antibiotic prescribing habits in the inpatient setting, according to a study published in the journal Infection Control & Hospital Epidemiology.
Researchers conducted semi-structured interviews — including open-ended questions and flexible probes based on participant responses — with 10 inpatient physicians-in-training and 20 inpatient supervising staff. The responses were analyzed using emergent thematic analysis.
Highlighted below are five findings from the study on prescribing influencing factors.
1. Although participants recognized the overuse of antibiotics, many admitted to prescribing antibiotics even when the clinical evidence of infection was uncertain.
2. Many physicians overprescribe antibiotics due to anxiety about missing an infection, whereas potential adverse effects of antibiotics did not strongly influence decision making.
3. Participants admitted to not routinely disclosing potential adverse effects of antibiotics to inpatients.
4. Physicians-in-training reported being strongly influenced by the antibiotic prescribing behavior of their supervising staff physicians.
5. Despite sometimes questioning their colleagues' antibiotic prescribing decisions, physicians frequently avoided providing direct feedback or critique because of either obstacles of hierarchy, infrequent face-to-face encounters or the awkwardness of such conversations.
According to the study authors, "a better understanding of these [professional and psychosocial] factors could be leveraged in future efforts to improve antibiotic prescribing practices in the inpatient setting."
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Considerable antibiotic use in neonatal ICUs lacks warrant
Physician competition, patient wealth and prescribing antibiotics: 5 things to know