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Performance of infectious diseases specialists, hospitalists, and other internal medicine physicians in antimicrobial case-based scenarios: Potential impact of antimicrobial stewardship programs at 16 Veterans' Affairs medical centers.
Graber, Christopher J; Simon, Alissa R; Zhang, Yue; Goetz, Matthew Bidwell; Jones, Makoto M; Butler, Jorie M; Chou, Ann F; Glassman, Peter A.
Afiliação
  • Graber CJ; Infectious Diseases Section, Veterans' Affairs (VA) Greater Los Angeles Healthcare System, Los Angeles, California.
  • Simon AR; Center for Healthcare Innovation, Implementation and Policy, VA Greater Los Angeles Healthcare System, Los Angeles, California.
  • Zhang Y; David Geffen School of Medicine, University of California-Los Angeles, Los Angeles, California.
  • Goetz MB; Center for Healthcare Innovation, Implementation and Policy, VA Greater Los Angeles Healthcare System, Los Angeles, California.
  • Jones MM; IDEAS Center, VA Salt Lake City Healthcare System, Salt Lake City, Utah.
  • Butler JM; Department of Medicine, University of Utah, Salt Lake City, Utah.
  • Chou AF; Division of Epidemiology, University of Utah, Salt Lake City, Utah.
  • Glassman PA; Infectious Diseases Section, Veterans' Affairs (VA) Greater Los Angeles Healthcare System, Los Angeles, California.
Infect Control Hosp Epidemiol ; 44(3): 400-405, 2023 03.
Article em En | MEDLINE | ID: mdl-35506398
OBJECTIVE: As part of a project to implement antimicrobial dashboards at select facilities, we assessed physician attitudes and knowledge regarding antibiotic prescribing. DESIGN: An online survey explored attitudes toward antimicrobial use and assessed respondents' management of four clinical scenarios: cellulitis, community-acquired pneumonia, non-catheter-associated asymptomatic bacteriuria, and catheter-associated asymptomatic bacteriuria. SETTING: This study was conducted across 16 Veterans' Affairs (VA) medical centers in 2017. PARTICIPANTS: Physicians working in inpatient settings specializing in infectious diseases (ID), hospital medicine, and non-ID/hospitalist internal medicine. METHODS: Scenario responses were scored by assigning +1 for answers most consistent with guidelines, 0 for less guideline-concordant but acceptable answers and -1 for guideline-discordant answers. Scores were normalized to 100% guideline concordant to 100% guideline discordant across all questions within a scenario, and mean scores were calculated across respondents by specialty. Differences in mean score per scenario were tested using analysis of variance (ANOVA). RESULTS: Overall, 139 physicians completed the survey (19 ID physicians, 62 hospitalists, and 58 other internists). Attitudes were similar across the 3 groups. We detected a significant difference in cellulitis scenario scores (concordance: ID physicians, 76%; hospitalists, 58%; other internists, 52%; P = .0087). Scores were numerically but not significantly different across groups for community-acquired pneumonia (concordance: ID physicians, 75%; hospitalists, 60%; other internists, 56%; P = .0914), for non-catheter-associated asymptomatic bacteriuria (concordance: ID physicians, 65%; hospitalists, 55%; other internists, 40%; P = .322), and for catheter-associated asymptomatic bacteriuria (concordance: ID physicians, 27% concordant; hospitalists, 8% discordant; other internists 13% discordant; P = .12). CONCLUSIONS: Significant differences in performance regarding management of cellulitis and low overall performance regarding asymptomatic bacteriuria point to these conditions as being potentially high-yield targets for stewardship interventions.
Assuntos

Texto completo: 1 Base de dados: MEDLINE Assunto principal: Bacteriúria / Veteranos / Doenças Transmissíveis / Médicos Hospitalares / Gestão de Antimicrobianos / Anti-Infecciosos Tipo de estudo: Guideline / Qualitative_research Limite: Humans Idioma: En Ano de publicação: 2023 Tipo de documento: Article

Texto completo: 1 Base de dados: MEDLINE Assunto principal: Bacteriúria / Veteranos / Doenças Transmissíveis / Médicos Hospitalares / Gestão de Antimicrobianos / Anti-Infecciosos Tipo de estudo: Guideline / Qualitative_research Limite: Humans Idioma: En Ano de publicação: 2023 Tipo de documento: Article