期刊
JOURNAL OF SPINAL CORD MEDICINE
卷 34, 期 1, 页码 16-21出版社
MANEY PUBLISHING
DOI: 10.1179/107902610X12886261091794
关键词
Spinal cord injuries; Infectious disease; Pneumonia; Drug resistance; Anti-bacterial agents; Azithromycin; Amoxicillin/clavulanate; Moxifloxacin; Antibiotic prescribing patterns; Attitude of health personnel
资金
- Department of Veterans Affairs, Office of Research and Development, Health Services Research and Development Service, SCI QUERI [98-000]
- Paralyzed Veterans of America Research Foundation [2562]
Context: Persons with spinal cord injury or disorder (SCI/D) are at increased risk for antibiotic resistance because of recurrent infections and subsequent use of antibiotics. However, there are no studies focused on providers who care for these patients and their perceptions regarding antibiotic use and resistance. Objective: To characterize SCI/D provider behavior and attitudes about antibiotic prescribing and resistance. Design/methods: Anonymous internet-based, cross-sectional survey. Participants: A total of 314 SCI/D clinicians who prescribe antibiotics (physicians, physician assistants, and nurse practitioners). Results: A total of 118 providers responded (37.6% response rate) including 80 physicians, 20 nurse practitioners, and 18 physician assistants. The majority of respondents agreed with statements regarding the societal impact of antibiotic resistance; only 17.8% agreed that they prescribed antibiotics more than they should, but 61.0% agreed that patient demand was a major reason for prescribing unnecessary antibiotics. The most frequent problematic organisms reported were: methicillin-resistant Staphylococcus aureus (83.1%), multidrug-resistant Pseudomonas (61.0%), and Clostridium difficile (57.6%). The most frequent antibiotics selected for outpatient treatment of community-acquired pneumonia treatment, based on a clinical scenario were azithromycin (36.4%) and respiratory fluoroquinolones (22.9%). Conclusion: These data show that the respondents are aware of and concerned with the problem of antibiotic resistance in their practice. Clinician respondents also endorsed the need to improve their own knowledge and that of their colleagues regarding appropriate antibiotic prescribing. These findings suggest that interventions should focus on provider education, particularly regarding appropriate antibiotic prescribing.
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