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抗生素使用:两所大学医院的知识和认知。

Antibiotic use: knowledge and perceptions in two university hospitals.

机构信息

Infection Control Unit, Bichat-Claude Bernard Hospital, Assistance publique-hôpitaux de Paris, and Denis Diderot University, Paris, France.

出版信息

J Antimicrob Chemother. 2011 Apr;66(4):936-40. doi: 10.1093/jac/dkq541. Epub 2011 Jan 26.

Abstract

OBJECTIVES

To investigate knowledge and perceptions about antibiotic prescription in two university hospitals.

METHODS

Physicians completed four case vignettes describing infections and a questionnaire. For each vignette, the physicians were asked to determine whether hospital admission and antibiotic treatment were needed; whether a treatment change was needed; and the duration of antibiotic treatment. The questionnaire collected data on beliefs and perceptions regarding antibiotic prescription.

RESULTS

Of 412 eligible physicians, 206 agreed to participate. Factors associated with a vignette score above the median were anaesthesiologist/intensivist (adjusted odds ratio, 3.09; P=0.02), perception of inappropriate antibiotic use as risky for the patient (adjusted odds ratio, 2.84; P=0.03) and self-efficacy (adjusted odds ratio, 2.18; P=0.02), whereas being a surgeon was associated with a vignette score lower than the median (adjusted odds ratio, 0.14; P<0.0001).

CONCLUSIONS

The high participation rate suggested awareness of antibiotic use. Educational programmes specifically targeted at surgeons are needed. We identified cognitive factors that affect knowledge of antibiotic prescription, and may help in the design of education programmes and interventions aimed at improving antibiotic use.

摘要

目的

调查两所大学医院的医生对抗生素处方的知识和认知。

方法

医生填写了四个描述感染的病例简介和一份调查问卷。对于每个病例简介,医生被要求判断是否需要住院和抗生素治疗;是否需要改变治疗方案;以及抗生素治疗的持续时间。调查问卷收集了有关抗生素处方的信念和认知的数据。

结果

在 412 名符合条件的医生中,有 206 名同意参与。与病例简介得分高于中位数相关的因素包括麻醉师/重症监护医生(调整后的优势比,3.09;P=0.02)、认为抗生素使用不当对患者有风险(调整后的优势比,2.84;P=0.03)和自我效能感(调整后的优势比,2.18;P=0.02),而外科医生的病例简介得分低于中位数(调整后的优势比,0.14;P<0.0001)。

结论

高参与率表明医生对抗生素使用有一定的认识。需要针对外科医生开展专门的教育计划。我们确定了影响抗生素处方知识的认知因素,这可能有助于设计旨在改善抗生素使用的教育计划和干预措施。

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