Drivers of Broad-Spectrum Antibiotic Overuse across Diverse Hospital Contexts-A Qualitative Study of Prescribers in the UK, Sri Lanka and South Africa.
Drivers of Broad-Spectrum Antibiotic Overuse across Diverse Hospital Contexts-A Qualitative Study of Prescribers in the UK, Sri Lanka and South Africa.
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DOI：
10.3390/antibiotics10010094
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发表时间：
2021-01-19
期刊：
影响因子：
--
通讯作者：
Krockow EM
中科院分区：
文献类型：
--
作者：
Tarrant C;Colman AM;Jenkins DR;Chattoe-Brown E;Perera N;Mehtar S;Nakkawita WMID;Bolscher M;Krockow EM
抗菌药物管理计划的重点是减少广谱抗生素（BSA）的过度使用，主要是通过干预措施改变处方行为。本研究的目的是确定多层次的影响BSA过度使用在不同的高收入和低收入，公共和私人，医疗背景。半结构化的采访进行了46开处方的医院在英国，斯里兰卡和南非，包括公共和私人提供者。访谈探讨了关于处方BSA的决策，使用BSA的驱动因素，以及BSA对各利益相关者的好处，并使用恒定的比较方法进行了分析。分析确定了BSA在个人，社会和结构层面过度使用的驱动因素。过度使用的结构性驱动因素在不同情况下差异很大，包括：与管理目标产生紧张关系的系统层面因素;医院内有限的物质资源;以及患者贫困，当地社区缺乏基础设施和资源。抗菌剂管理需要包括努力减少对BSA的依赖，以解决特定环境的结构性条件。
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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影响因子：
4
作者：
Chandler, Clare I. R.
通讯作者：
Chandler, Clare I. R.
影响因子：
--
作者：
Hecker, MT;Aron, DC;Donskey, CJ
通讯作者：
Donskey, CJ
DOI：
10.1093/cid/cit212
发表时间：
2013-07
期刊：
Clinical infectious diseases : an official publication of the Infectious Diseases Society of America
影响因子：
--
作者：
Charani E;Castro-Sanchez E;Sevdalis N;Kyratsis Y;Drumright L;Shah N;Holmes A
通讯作者：
Holmes A
影响因子：
8.4
作者：
Pierce, Jacob;Apisarnthanarak, Anucha;Stevens, Michael P.
通讯作者：
Stevens, Michael P.
影响因子：
3.7
作者：
Charani, Esmita;Smith, Ingrid;Holmes, Alison Helen
通讯作者：
Holmes, Alison Helen