Zhang Jingmin, Shi Haipeng, Xia Yanmei, Zhu Zhenghua, Zhang Yaojun
Department of Intensive Care Unit, Shanxi Bethune Hospital, Shanxi Academy of Medical Sciences, Tongji Shanxi Hospital, Third Hospital of Shanxi Medical University, Taiyuan, Shanxi, China.
Department of Intensive Care Unit, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei, China.
Front Med (Lausanne). 2025 Jan 15;11:1454521. doi: 10.3389/fmed.2024.1454521. eCollection 2024.
Sepsis management in the Intensive Care Unit (ICU) presents a significant challenge within contemporary healthcare. The primary challenge lies in ensuring the timely and appropriate utilization of antibiotics. Inappropriate antibiotic use in sepsis management can result in a multitude of adverse outcomes. There has been insufficient focus on thoroughly understanding and resolving the issues related to the improper application of antibiotics in sepsis treatment by physicians and pharmacists. This gap in research is concerning, considering its potential implications for patient outcomes and public health. This study aimed to assess the knowledge, attitudes and practices (KAP) among physicians and pharmacists toward antibiotic use in sepsis.
This web-based cross-sectional study was conducted at Shanxi Bethune Hospital between June 2023 and October 2023. A self-designed questionnaire was developed to collect demographic information of physicians and pharmacists, and to assess their knowledge, attitudes and practices toward antibiotic use in sepsis.
A total of 200 valid questionnaires were collected. Among the participants, 115 (57.5%) were female and 118 (59%) had experience with ICU patient management. The mean knowledge, attitudes and practices scores were 10.2 ± 1.14 (possible range: 0-12), 45.88 ± 4.00 (possible range: 10-50) and 48.38 ± 5.84 (possible range: 11-55), respectively. Multivariate logistic regression showed that attitudes (OR = 1.59, 95%CI: 1.34-1.87, < 0.001), work experience of 15 years and above (OR = 7.17, 95%CI: 2.33-22.0, = 0.001) were independently associated with proactive practices. For physicians, the structural equation model (SEM) demonstrated that attitudes directly affects practices, as indicated by a path coefficient of 0.91 ( < 0.001). For pharmacist, SEM showed that knowledge directly affect attitudes, with a path coefficient of 0.75 ( < 0.024), moreover, attitudes directly affect practices, with a path coefficient of 0.87 ( < 0.001).
The findings revealed that physicians and pharmacists have sufficient knowledge, active attitudes, and proactive practices toward the antibiotic use in sepsis. Nonetheless, the findings also reveal the persistence of certain misconceptions, alongside notable shortcomings in both attitudes and practices. Comprehensive training programs are imperative for enhancing the practices of physicians and pharmacists in this field.
重症监护病房（ICU）中的脓毒症管理是当代医疗保健领域面临的一项重大挑战。主要挑战在于确保及时、恰当地使用抗生素。脓毒症管理中抗生素使用不当会导致多种不良后果。医生和药剂师在充分理解和解决脓毒症治疗中抗生素使用不当相关问题方面的关注不足。考虑到其对患者预后和公共卫生的潜在影响，这一研究空白令人担忧。本研究旨在评估医生和药剂师在脓毒症抗生素使用方面的知识、态度和实践（KAP）。
这项基于网络的横断面研究于2023年6月至2023年10月在山西白求恩医院进行。设计了一份自填式问卷，以收集医生和药剂师的人口统计学信息，并评估他们在脓毒症抗生素使用方面的知识、态度和实践。
共收集到200份有效问卷。参与者中，115名（57.5%）为女性，118名（59%）有ICU患者管理经验。知识、态度和实践的平均得分分别为10.2±1.14（可能范围：0 - 12）、45.88±4.00（可能范围：10 - 50）和48.38±5.84（可能范围：11 - 55）。多因素逻辑回归显示，态度（OR = 1.59，95%CI：1.34 - 1.87，P < 0.001）、15年及以上工作经验（OR = 7.17，95%CI：2.33 - 22.0，P = 0.001）与积极实践独立相关。对于医生，结构方程模型（SEM）表明态度直接影响实践（路径系数为0.91，P < 0.001）。对于药剂师，SEM显示知识直接影响态度（路径系数为0.75，P < 0.024），此外，态度直接影响实践（路径系数为0.87，P < 0.001）。
研究结果表明，医生和药剂师在脓毒症抗生素使用方面有足够的知识、积极的态度和主动的实践。尽管如此，研究结果也揭示了某些误解的存在，以及态度和实践方面的显著不足。全面的培训计划对于提高医生和药剂师在该领域的实践至关重要。
