Division of General Internal Medicine, Department of Internal Medicine, University of Utah School of Medicine, Salt Lake City, Utah.
Division of Health System Innovation & Research, Department of Population Health Science, University of Utah School of Medicine, Salt Lake City, Utah.
Infect Control Hosp Epidemiol. 2023 Apr;44(4):570-577. doi: 10.1017/ice.2022.136. Epub 2022 Jun 7.
To assess association of pharmacist gender with acceptance of antibiotic stewardship recommendations.
A retrospective evaluation of the Reducing Overuse of Antibiotics at Discharge (ROAD) Home intervention.
The study was conducted from May to October 2019 in a single academic medical center.
The study included patients receiving antibiotics on a hospitalist service who were nearing discharge.
During the intervention, clinical pharmacists (none who had specialist postgraduate infectious disease residency training) reviewed patients on antibiotics and led an antibiotic timeout (ie, structured conversation) prior to discharge to improve discharge antibiotic prescribing. We assessed the association of pharmacist gender with acceptance of timeout recommendations by hospitalists using logistic regression controlling for patient characteristics.
Over 6 months, pharmacists conducted 295 timeouts: 158 timeouts (53.6%) were conducted by 12 women, 137 (46.4%) were conducted by 8 men. Pharmacists recommended an antibiotic change in 82 timeouts (27.8%), of which 51 (62.2%) were accepted. Compared to male pharmacists, female pharmacists were less likely to recommend a discharge antibiotic change: 30 (19.0%) of 158 versus 52 (38.0%) of 137 (P < .001). Female pharmacists were also less likely to have a recommendation accepted: 10 (33.3%) of 30 versus 41 (8.8%) of 52 (P < .001). Thus, timeouts conducted by female versus male pharmacists were less likely to result in an antibiotic change: 10 (6.3%) of 158 versus 41 (29.9%) of 137 (P < .001). After adjustments, pharmacist gender remained significantly associated with whether recommended changes were accepted (adjusted odds ratio [aOR], 0.10; 95%confidence interval [CI], 0.03-0.36 for female versus male pharmacists).
Antibiotic stewardship recommendations made by female clinical pharmacists were less likely to be accepted by hospitalists. Gender bias may play a role in the acceptance of clinical pharmacist recommendations, which could affect patient care and outcomes.
评估药剂师性别与接受抗生素管理建议之间的关联。
对减少出院时抗生素过度使用（ROAD）家庭干预的回顾性评估。
该研究于 2019 年 5 月至 10 月在一家学术医疗中心进行。
该研究纳入了即将出院的接受医院服务抗生素治疗的患者。
在干预期间，临床药剂师（均未接受过专科传染病住院医师培训）对接受抗生素治疗的患者进行评估，并在出院前进行抗生素超时（即结构化对话），以改善出院时的抗生素处方。我们使用逻辑回归评估药剂师性别与医院医生接受超时建议之间的关联，控制患者特征。
在 6 个月期间，药剂师进行了 295 次超时：158 次超时（53.6%）由 12 名女性进行，137 次超时（46.4%）由 8 名男性进行。药剂师建议改变抗生素治疗的有 82 次超时（27.8%），其中 51 次超时（62.2%）被接受。与男性药剂师相比，女性药剂师不太可能建议改变出院时的抗生素治疗：158 次中有 30 次（19.0%），137 次中有 52 次（38.0%）（P<.001）。女性药剂师的建议也不太可能被接受：158 次中有 10 次（33.3%），137 次中有 41 次（8.8%）（P<.001）。因此，由女性药剂师进行的超时比由男性药剂师进行的超时更不可能导致抗生素治疗的改变：158 次中有 10 次（6.3%），137 次中有 41 次（29.9%）（P<.001）。调整后，药剂师性别仍然与建议的改变是否被接受显著相关（调整后的优势比[aOR]，女性药剂师与男性药剂师相比为 0.10；95%置信区间[CI]为 0.03-0.36）。
医院医生不太可能接受女性临床药剂师提出的抗生素管理建议。性别偏见可能在接受临床药剂师建议方面发挥作用，这可能会影响患者的治疗效果和结果。
