Scripps La Jolla, 9888 Genesee Avenue, La Jolla, CA 92037, USA; The Brooklyn Hospital Center, 121 DeKalb Avenue, Brooklyn, NY 11201, USA.
Long Island University, 1 University Plaza, Brooklyn, NY 11201, USA.
J Glob Antimicrob Resist. 2016 Mar;4:21-27. doi: 10.1016/j.jgar.2016.01.004. Epub 2016 Feb 8.
Antimicrobial stewardship programmes (ASPs) are used in numerous institutions in an effort to promote safe and effective antimicrobial use. The objectives of this study were to (i) assess physicians' perceptions, attitudes and knowledge about antimicrobial use, resistance and the ASP at The Brooklyn Hospital Center (TBHC) and (ii) measure physicians' beliefs and attitudes to the current system of prior authorisation of antimicrobials. A 75-item, anonymous, voluntary, traditional paper and pencil survey was distributed to resident physicians at TBHC. Multiple-choice, 5-point Likert scale and knowledge-based questions were utilised. Of the 261 residents, 129 (49%) completed the survey. The respondents significantly believed that antibiotics are overused more frequently nationally vs. locally [117/129 (91%) vs. 91/129 (71%); P=0.0001]. Although 49% (63/129) felt that other providers overprescribe antibiotics, only 26% (34/129) agreed that they themselves were contributing to the current problem (P=0.0003). Fifty-seven percent of respondents agreed that individual patient care is improved by having an antibiotic approval programme; however, 45% of respondents reported that the antibiotic approval programme limits their autonomy in choosing antibiotics. Compared with surgical residents, medical residents were more likely (33% vs. 13%; P=0.02) to feel that the antibiotic approval programme forced them to choose an inappropriate antibiotic. On the antibiotic knowledge assessment segment of the survey, there was no difference in score when stratified by specialty or years of postgraduate training. Based on the survey results, house staff are supportive of antimicrobial stewardship and feel that the ASP is valuable for patient care.
抗菌药物管理计划（ASPs）在众多机构中被用于促进安全有效的抗菌药物使用。本研究的目的是：（i）评估布鲁克林医院中心（TBHC）医生对抗菌药物使用、耐药性和 ASP 的认知、态度和知识；（ii）衡量医生对抗菌药物事先授权的现行制度的信念和态度。我们向 TBHC 的住院医师发放了一份 75 项、匿名、自愿、传统的纸质和铅笔调查问卷。我们使用了多项选择题、5 分李克特量表和基于知识的问题。在 261 名住院医师中，有 129 名（49%）完成了调查。受访者明显认为，抗生素在全国范围内的过度使用比在当地更为频繁[117/129（91%）比 91/129（71%）；P=0.0001]。尽管 49%（63/129）的人认为其他提供者过度开具抗生素，但只有 26%（34/129）的人认为自己是造成当前问题的原因（P=0.0003）。57%的受访者同意，通过抗生素批准计划可以改善个体患者的护理；然而，45%的受访者报告称，抗生素批准计划限制了他们选择抗生素的自主权。与外科住院医师相比，内科住院医师更有可能（33%比 13%；P=0.02）认为抗生素批准计划迫使他们选择不适当的抗生素。在调查的抗生素知识评估部分，根据专业或研究生培训年限进行分层，得分没有差异。根据调查结果，住院医师对抗菌药物管理计划表示支持，并认为该计划对患者护理具有价值。
