Exploring Physicians’ Views, Perceptions and Experiences about Broad-Spectrum Antimicrobial Prescribing in a Tertiary Care Hospital Riyadh, Saudi Arabia: A Qualitative Approach

Abstract

Antimicrobial resistance (AMR) is a global public health threat associated with increased mortality, morbidity and costs. Inappropriate antimicrobial prescribing, particularly of broad-spectrums antimicrobials (BSAs), is considered a major factor behind growing AMR. The aim of this study was to explore physician perception and views about BSAs and factors that impact upon their BSAs prescribing decisions. Qualitative semistructured telephone interviews over an eleven-week period were conducted with physicians in a single tertiary care hospital in Riyadh, Saudi Arabia. Purposeful and snowball sampling techniques were adopted as sampling strategy. All interviews were audio recorded, transcribed verbatim, uploaded to NVivo® software and analysed following thematic analysis approach. Four major themes emerged: views on BSAs, factors influencing BSA prescribing and antimicrobial stewardship: practices and barriers and recommendations to improve appropriate BSA prescribing. Recommendations for the future include improving clinical knowledge, feedback on prescribing, multidisciplinary team decision-making and local guideline implementation. Identification of views and determinants of BSA prescribing can guide the design of a multifaceted intervention to support physicians and policymakers to improve antimicrobial prescribing practices.

Bidirectional Interaction between Tetracyclines and Gut Microbiome

“…A study monitoring the prescriptions for outpatient parenteral antibiotic therapy found that up to 50% of broad-spectrum prescriptions could have been narrowed [ 10 ]. However, even in instances where narrow-spectrum antibiotics are more justified, physicians still have the tendency to prescribe broad-spectrum antibiotics [ 11 ]. This could be because prescribing practices are often habitual, and decisions may be made using treatments most familiar to the prescriber, prompting the use of all-encompassing broad-spectrum antibiotics [ 12 ].…”