School of Nursing and Midwifery, Deakin University, Geelong, VIC, Australia.
School of Nursing and Midwifery, Deakin University, Geelong, VIC, Australia; Centre for Quality and Patient Safety Research - Eastern Health Partnership, Box Hill, VIC, Australia.
Am J Infect Control. 2018 Apr;46(4):425-430. doi: 10.1016/j.ajic.2017.09.022. Epub 2017 Nov 10.
Effective hospital-wide antimicrobial stewardship (AMS) programs need multidisciplinary engagement; however, clinicians' attitudes have not been investigated in Thailand where AMS is in early development. The aim of this study was to explore Thai clinicians' (doctors, nurses, and pharmacists) perceptions and attitudes toward AMS.
A paper-based survey was distributed in a 1,000-bed university hospital in Bangkok, Thailand, between November 9, 2015, and December 21, 2015. A total of 1,087 clinicians participated: 392 doctors, 613 nurses, and 82 pharmacists.
Most participants agreed that improving antimicrobial prescribing would decrease antimicrobial resistance (AMR) and should be a priority of hospital policy. Doctors were less likely to agree with policies that limit antimicrobial prescribing (P < .001) than nurses or pharmacists, and were less likely to be interested in participating in AMS education than other clinicians (P < .001). Pharmacists indicated higher agreement with the statement, recommending that a specialist team provide individualized antimicrobial prescribing advice (P < .01) and that feedback improves antimicrobial selection (P < .001). Nurses were less likely to agree that community antibiotic use (P < .001) or patient pressure for antibiotics contribute to AMR (P < .001).
AMS programs are vital to improving antimicrobial use by clinicians. Understanding clinicians' attitudes and perceptions related to AMS is important to ensure that AMS programs developed address areas relevant to local clinical needs.
有效的全院抗菌药物管理（AMS）计划需要多学科参与；然而，在 AMS 处于早期发展阶段的泰国，尚未调查临床医生的态度。本研究旨在探讨泰国临床医生（医生、护士和药剂师）对 AMS 的看法和态度。
2015 年 11 月 9 日至 12 月 21 日，在曼谷的一家 1000 床位的大学医院，以纸质问卷的形式进行了调查。共有 1087 名临床医生参与了这项研究：392 名医生、613 名护士和 82 名药剂师。
大多数参与者认为，改善抗菌药物的处方将减少抗菌药物耐药性（AMR），并应成为医院政策的重点。与护士或药剂师相比，医生不太可能同意限制抗菌药物处方的政策（P<.001），并且不太可能对参与 AMS 教育感兴趣（P<.001）。药剂师表示更同意以下说法，即应由专门小组提供个体化的抗菌药物处方建议（P<.01），并且反馈可改善抗菌药物选择（P<.001）。护士不太可能同意社区抗生素使用（P<.001）或患者对抗生素的压力导致 AMR（P<.001）。
AMS 计划对于改善临床医生对抗生素的使用至关重要。了解临床医生与 AMS 相关的态度和看法，对于确保制定的 AMS 计划能够解决与当地临床需求相关的问题非常重要。
