Research highlights patterns of antibiotics prescribing
According to new research by Imperial College London, UK, antibiotics prescribing by doctors is influenced by team dynamics and cultures within hospitals. The researchers involved spent more than 500 hours with medical and surgical teams whilst observing and documenting team and individual behaviours around decision making for antibiotic prescribing and infection management. In addition, the researchers interviewed 23 staff members to gain further insight into the challenges faced when prescribing antibiotics.
The research is funded by the National Institute for Health Research, the Economic and Social Research Council, and Public Health England, and is part of a larger research programme that also considered patient outcomes of the differences in decision making across specialities, by following a group of patients in medicine and surgery.
Dr Esmita Charani, senior pharmacist and leading the study, Imperial’s Department of Medicine, said: “This research builds on our existing work, which focuses on trying to understand how human behaviours influence medical decision making. Understanding culture and context is highly relevant when trying to understand how and why interventions and policies fail to be implemented as expected. Antibiotic management in surgery is complex not because there is less attention to infection management in surgical teams, but rather because of the different way in which surgical teams prioritise the care of their patients. Antibiotic prescribing in surgery is driven by a need to prevent infections following a surgical intervention. Understanding how surgical and medical specialties determine risks associated with infection management can lead to developing more tailored solutions which can optimise antibiotic prescribing and improve patient outcomes.”
According to the study, the risks associated with infections are assessed differently across the specialties and this drives decision making, and there needs to be more focus on addressing antibiotic use in the surgical pathway.
Professor Alison Holmes, from Imperial’s Department of Medicine and Principal Investigator of the research, said: “Between 30-50 per cent of patients in hospitals undergo surgery. Therefore, addressing behaviours related to antibiotic use across the surgical pathway (before, during and after surgery) is key to tackling important drivers of antimicrobial resistance. Our current programme of research is investigating how we can improve infection prevention behaviours and optimise antibiotic use in surgery across different healthcare settings.”