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[细菌耐药性与抗生素处方:医院医生认知、态度及知识的调查]

[Bacterial resistance and antibiotic prescription: a survey of hospital physician perception, attitude, and knowledge].

作者信息

Naqvi A, Pulcini C

机构信息

Service d'infectiologie, hôpital l'Archet 1, CHU de Nice, route Saint-Antoine de Ginestière, BP 3079, 06202 Nice cedex 3, France.

出版信息

Med Mal Infect. 2010 Nov;40(11):625-31. doi: 10.1016/j.medmal.2010.04.003.

Abstract

OBJECTIVE

The authors' goal was to assess physicians' perception of antibiotic prescribing practice and of bacterial resistance.

DESIGN

We questioned 503 interns and senior physicians in the Nice University Hospital.

RESULTS

Three hundred and twenty-two out of five hundred and three (64 %) physicians answered the questionnaire. Antibiotic resistance was perceived as a national problem by 98 % of physicians, but only 74 % rated the problem as important in their own daily practice. Fifty-nine percent of interns and 34 % of senior physicians respectively had received some training on antibiotic prescribing in the past 12 months. Only 33 % of physicians knew the exact prevalence of MRSA in their hospital. Senior physicians were more confident than interns when prescribing an antibiotic. The three issues they were the less confident with were: indications of antibiotic combinations, reassessment, and duration of antibiotic treatment. They were aware that antibiotic overuse, prescription of broad-spectrum molecules, or subtherapeutic doses of antibiotics were the three major causes of antibiotic resistance. They believed that the most useful measures to improve antibiotic prescription were: availability of guidelines, specific courses, readily accessible advice from an infectious diseases specialist, and audit plus feedback.

CONCLUSIONS

The collected data provides useful information for the implementation of strategies to optimize adherence to good antimicrobial stewardship.

摘要

目的

作者的目标是评估医生对抗生素处方实践和细菌耐药性的认知。

设计

我们对尼斯大学医院的503名实习生和资深医生进行了问卷调查。

结果

503名医生中有322名(64%)回答了问卷。98%的医生认为抗生素耐药性是一个全国性问题,但只有74%的医生认为该问题在他们自己的日常实践中很重要。在过去12个月里,分别有59%的实习生和34%的资深医生接受了一些抗生素处方方面的培训。只有33%的医生知道他们医院耐甲氧西林金黄色葡萄球菌(MRSA)的确切流行率。在开抗生素处方时,资深医生比实习生更有信心。他们最缺乏信心的三个问题是:抗生素联合使用的指征、重新评估以及抗生素治疗的持续时间。他们意识到抗生素过度使用、广谱分子的处方或抗生素的亚治疗剂量是抗生素耐药性的三个主要原因。他们认为改善抗生素处方最有用的措施是:提供指南、开设特定课程、能方便地获得传染病专家的建议以及审核并反馈。

结论

所收集的数据为实施优化抗菌药物合理使用策略提供了有用信息。

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