期刊
ANTIBIOTICS-BASEL
卷 10, 期 1, 页码 -出版社
MDPI
DOI: 10.3390/antibiotics10010094
关键词
antimicrobial stewardship; antibacterial agents; hospitals; physicians; decision making; qualitative methods; UK; South Africa; Sri Lanka
资金
- Global Challenges Research Fund - Economic and Social Research Council (ESRC) on behalf of the Research Councils United Kingdom (RCUK) [ES/P004784/1]
- ESRC [ES/P004784/1] Funding Source: UKRI
This study identified multi-level influences on broad-spectrum antibiotic overuse, with drivers found at individual, social, and structural levels. Structural drivers varied significantly across environments, highlighting the need for antimicrobial stewardship efforts to address context-specific conditions.
Antimicrobial stewardship programs focus on reducing overuse of broad-spectrum antibiotics (BSAs), primarily through interventions to change prescribing behavior. This study aims to identify multi-level influences on BSA overuse across diverse high and low income, and public and private, healthcare contexts. Semi-structured interviews were conducted with 46 prescribers from hospitals in the UK, Sri Lanka, and South Africa, including public and private providers. Interviews explored decision making about prescribing BSAs, drivers of the use of BSAs, and benefits of BSAs to various stakeholders, and were analyzed using a constant comparative approach. Analysis identified drivers of BSA overuse at the individual, social and structural levels. Structural drivers of overuse varied significantly across contexts and included: system-level factors generating tensions with stewardship goals; limited material resources within hospitals; and patient poverty, lack of infrastructure and resources in local communities. Antimicrobial stewardship needs to encompass efforts to reduce the reliance on BSAs as a solution to context-specific structural conditions.
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