Critical points in the pathway of antibiotic prescribing in a children's hospital: the Antibiotic Mapping of Prescribing (ABMAP) study

Bashir, Amreen; Gray, J.; Bashir, Shahreen; Ahmed, Rabia; Theodosiou, Eirini

doi:10.1016/j.jhin.2018.07.038

Cited by 7 publications

(7 citation statements)

References 8 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…This effect has been demonstrated for antifungal stewardship with one group reporting a 73% reduction in spending on antifungals following the employment of an infectious diseases specialist [ 9 ]. The specific challenges of ASPs in paediatric settings have been reported [ 10 ], along with recognition that training and education alone is unlikely to be successful and a more directive approach may be more efficacious [ 11 ].…”

Section: Funding Sourcesmentioning

confidence: 99%

Antimicrobial stewardship: a COVID casualty?

Lynch

Mahida

Gray

2020

Journal of Hospital Infection

Self Cite

View full text Add to dashboard Cite

Section: Funding Sourcesmentioning

confidence: 99%

Antimicrobial stewardship: a COVID casualty?

Lynch

Mahida

Gray

2020

Journal of Hospital Infection

Self Cite

View full text Add to dashboard Cite

“…20 Furthermore, the subjective views of consultants and different ward protocols, on how to treat patients, may have led to the differing antibiotic prescription for patients across the cohort. We have previously found that pediatricians tested in clinical vignettes are inclined to over treat with antibiotics, 21 which may account for the hesitance to de-escalate antibiotic observed in this study.…”

Section: Discussionmentioning

confidence: 74%

Appropriateness of Antibiotic Treatment Review following Blood Culture Collection

Dhanda

Gray

Bashir

et al. 2019

J Pediatr Infect Dis

View full text Add to dashboard Cite

Objective Inappropriate antibiotic treatment can significantly affect antimicrobial resistance, resulting in treatments becoming less effective in the future. Previous studies have not identified the possible de-escalation rate. The aim of this study was to assess the appropriateness of antibiotic treatment in patients who have a blood culture collected, in particular, calculating how many days of antibiotics can be de-escalated. Methods A patient series, observational study was conducted that included all patient blood culture, regardless of whether they were positive or negative, over a period of 4 days. The study was repeated three times to attain a larger sample. The adequacy of antibiotic treatment was determined based on microbiology results, prescription drug administration, and patient notes/charts. Results Of the 69 suitable cases, 36 (52.17%) received appropriate treatment and 33 (47.83%) received inappropriate treatment. Of the inappropriate cases, it was calculated that 83 days of de-escalation were possible. Fifteen (21%) of the cases could have de-escalated use of meropenem. Conclusion The results highlight that there is opportunity to review and de-escalate patient's treatment, after taking a blood culture and practices such as rationalizing antibiotic choices and educating physicians on reviewing antibiotics is appropriate.

show abstract

“…Our review showed that interaction and relationships with colleagues 34 , 60 and expectations of patients 28 , 35–37 , 58 , 59 , 77 , 79–90 are important contributors to prescription decisions, suggesting that social interactions are important aspects to consider when discussing the problem of antimicrobial overuse. Humans are social animals, and maintaining positive social relationships is vital to their wellbeing.…”

Section: Behavioural Analysis Of the Factors Underlying Prescription ...mentioning

confidence: 94%

“…In the USA, more prescriptions are made in the South and Northeast, 47 , 69 and in areas with a high density of providers and clinics, potentially due to competition. 99 Additionally, single-handed 97 and non-training 97 , 100 practices, as well as practices with limited resources, 34 , 70 , 79 have higher prescription rates. On the other hand, having consistent patterns of prescribing within the practice, supportive practice policies, and enough resources such as consultation time, contribute to more prudent antimicrobial use.…”

Section: Behavioural Analysis Of the Factors Underlying Prescription ...mentioning

confidence: 99%

A scoping review and behavioural analysis of factors underlying overuse of antimicrobials

Poluektova

Robertson

Rafferty

et al. 2023

JAC-Antimicrobial Resistance

View full text Add to dashboard Cite

Background Overuse of antimicrobials is a challenging global issue that contributes to antimicrobial resistance. Despite widespread awareness of the problem among members of the medical community and various attempts to improve prescription practices, existing antimicrobial stewardship programmes are not always effective. In our view, this may reflect limited understanding of factors that influence prescription of antimicrobials as empirical therapy, implying a need to address the psychological mechanisms behind some of the specific behaviours involved. Objectives To identify factors that influence the antimicrobials prescription as empirical therapy, and to relate these factors to findings from behavioural science. Methods We conducted a scoping review of the literature on the factors underlying antimicrobial prescription decisions, following the protocol designed using PRISMA guidelines. Results and conclusions From a final sample of 90 sources, we identified ten factors important in antimicrobial prescription decisions. In the second stage of our analysis, we grouped them into five final categories: (1) nature of the decision, (2) social influences, (3) individual differences, (4) characteristics of the patient, (5) context. We analyse these categories using a behavioural science perspective.

show abstract

Critical points in the pathway of antibiotic prescribing in a children's hospital: the Antibiotic Mapping of Prescribing (ABMAP) study

Abstract: There was a marked disparity between prescribers, self-reporting of prescribing behaviour and responses to clinical scenarios. It was not clear whether training alone would change behaviours. Prescribers desired a directive mechanism to support antibiotic prescribing and stewardship.

Cited by 7 publications

References 8 publications

Antimicrobial stewardship: a COVID casualty?

Antimicrobial stewardship: a COVID casualty?

Appropriateness of Antibiotic Treatment Review following Blood Culture Collection

A scoping review and behavioural analysis of factors underlying overuse of antimicrobials

Contact Info

Product

Resources

About