Knowledge of Centers for Disease Control and Prevention guidelines for the use of vancomycin at a large tertiary care children’s hospital

Misprescription of antibiotics in primary care: a critical systematic review of its determinants

“…The 46 papers included could be separated into two blocks, according to whether the unit of analysis used was doctors (31 studies) [10,11,15–22,24–30,32–35,37–39,41–44,47,48,51] or some other item (clinical histories, prescriptions, etc.) [6–9,12–14,23,31,36,40,45,49,50].…”

“…In the 31 studies included in the block which studied doctors [10,11,15–22,24–30,32–35,37–39,41–44,47,48,51], the median percentage participation was 65%, and the data were collected by means of questionnaires in 27 cases [10,11,15–22,25–27,29,30,33–35,37–39,41–43,47,48,51] (with this procedure being combined with collection based on a review of clinical histories in four cases [18,19,42,43] and a review of prescriptions in one case) [37], and through observers/actors present at the medical visit in four cases [24,28,32,49]. Questionnaires were distributed by post in over 50% of cases [10,16,19,24–27,29,30,34,38,39,51]; nine were self‐administered [11,18,20,21,33,35,37,47,48], four made no mention of the method of distribution [15,22,28,41] and one took the form of a telephone survey [17].…”

“…In terms of the disease treated, most studies focused on respiratory infection in its different spectra (ranging from the common cold to acute bronchitis) [7,9–13,15–22,26–32,34,36–39,41–45,47–49]. In four no specific disease was mentioned [6,23,25,51], in three respiratory infection was combined with others, such as urinary tract infections or diarrhoea [14,46,50], two addressed the topic of prophylaxis in Caesarean section [33,40], and surgical infection was targeted in one [24] and urinary infection in another [8].…”

“…The study setting was primary care in 35 of the 46 studies [6–11,13–23,26–28,31,32,35,37,39,41–45,48,50,51], hospital care in six [24,25,33,36,40,49] and both in the remainder (five papers) [12,29,30,34,38]. The most widely studied professionals were general practitioners (GPs), followed by paediatricians.…”

Lack of chart reminder effectiveness on family medicine resident JNC-VI and NCEP III guideline knowledge and attitudes

“…Resident and practicing physicians have reported positive attitudes toward these guidelines, however evidence demonstrates a relative failure of these guidelines to actually change clinical practice patterns [1-9]. A recent study concerning asthma practice guidelines reported that only 44% of family physicians surveyed used any practice guidelines routinely, and only 55% had seen the asthma guidelines [6]. There has been a lack of recommendations concerning successful implementation strategies, despite extensive efforts toward guideline development and distribution.…”