Behavioral Approach to Appropriate Antimicrobial Prescribing in Hospitals
JAMA Internal Medicine (05/01/17) Sikkens, Jonne J.; van Agtmael, Michiel A.; Peters, Edgar J. G.
A recent study investigated whether an antimicrobial stewardship approach, grounded in behavioral theory and focusing on preserving prescriber autonomy and participation, was effective in increasing the appropriateness of antimicrobial prescribing in hospitals. The Dutch Unique Method for Antimicrobial Stewardship study was conducted at seven clinical departments in a tertiary care medical center and a general teaching hospital in the Netherlands. The study included physicians who prescribed systemic antimicrobial drugs for any indication for patients admitted to the participating departments during the study period. Prescribers were given a free choice of how to improve their antimicrobial prescribing. In all, 1,121 patient cases with 700 antimicrobial prescriptions were studied during the baseline period, and there were 882 patient cases with 531 antimicrobial prescriptions during the intervention period. At 12-month follow-up, the mean antimicrobial appropriateness rose to 77.4 percent from 64.1 percent at intervention start. The researchers noted no reduction in antimicrobial consumption. Based on their findings, the researchers conclude the participatory approach based on behavioral theory was effective. The unique and inexpensive approach can be used in various types of hospital departments, they add.
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