Bowers Dana R, Secaira Clara, Sandoval Nancy, Melgar Mario, Chavez Nuria, Lou-Meda Randall, Maldonado Herberth, Ramay Brooke M
Department of Pharmacotherapy, Washington State University College of Pharmacy and Pharmaceutical Sciences, Yakima, WA, USA.
Center for Health Studies, Universidad del Valle de Guatemala, Guatemala City, Guatemala.
Antimicrob Steward Healthc Epidemiol. 2025 Aug 18;5(1):e188. doi: 10.1017/ash.2025.10089. eCollection 2025.
To describe antimicrobial prescribing practices in 4 hospitals in Guatemala to guide the development of an ongoing antimicrobial stewardship (AS) project.
A cross-sectional mixed methodologies descriptive study design.
Practicing physicians from 4 hospitals (2 tertiary public hospitals and 2 specialty referral hospitals) within Guatemala City.
All participants responded to a survey to ascertain 3 key areas of antimicrobial prescription practices: identify key players, communication among key players, and perceptions and behaviors regarding antimicrobial prescribing. A subset of respondents participated in semi-structured interviews to further explore experiences with AS team dynamics and communication.
One hundred and ten participants completed the survey ( = 110/145, 75.8%), and 79 completed the interview ( = 79/110, 71.8%). Antimicrobial prescribing is led by physicians who are responsible for maintaining communication with infectious disease physicians. The limited role of the pharmacist and the more predominant role of the microbiologist in antimicrobial selection were notable despite similar levels of training. Efficient communication about prescribing was perceived primarily among physicians, although existing hierarchies within the healthcare system negatively influenced decision-making strategies. Participants reported difficulty in choosing an antibiotic and indicated a preference for broad-spectrum antimicrobial use.
The existing structure between physicians in hospitals facilitates antimicrobial prescribing practices. However, optimization of antimicrobial use may occur if multidisciplinary teams participate in antimicrobial selection activities. The results of this study provide valuable insight and can be used as a starting point toward the implementation of effective AS strategies within Guatemala and other similar countries in Central America and the Caribbean.
描述危地马拉4家医院的抗菌药物处方行为，以指导正在进行的抗菌药物管理（AS）项目的开展。
横断面混合方法描述性研究设计。
危地马拉城4家医院（2家公立三级医院和2家专科转诊医院）的执业医师。
所有参与者均对一项调查做出回应，以确定抗菌药物处方行为的3个关键领域：识别关键参与者、关键参与者之间的沟通以及对抗菌药物处方的看法和行为。一部分受访者参与了半结构化访谈，以进一步探讨在AS团队动态和沟通方面的经验。
110名参与者完成了调查（=110/145，75.8%），79名完成了访谈（=79/110，71.8%）。抗菌药物处方由负责与感染病医师沟通的医师主导。尽管培训水平相似，但药剂师的作用有限，而微生物学家在抗菌药物选择中作用更为突出，这一点值得注意。尽管医疗系统内现有的层级结构对决策策略有负面影响，但主要在医师之间存在关于处方的有效沟通。参与者报告在选择抗生素方面存在困难，并表示倾向于使用广谱抗菌药物。
医院医师之间的现有结构有利于抗菌药物处方行为。然而，如果多学科团队参与抗菌药物选择活动，可能会优化抗菌药物的使用。本研究结果提供了有价值的见解，可作为在危地马拉以及中美洲和加勒比地区其他类似国家实施有效AS策略的起点。
