Balancing the risks to individual and society : a systematic review and synthesis of qualitative research on antibiotic prescribing behaviour in hospitals
| dc.contributor.author | Krockow, E. M. | en_ZA |
| dc.contributor.author | Colman, A. M. | en_ZA |
| dc.contributor.author | Chattoe-Brown, E. | en_ZA |
| dc.contributor.author | Jenkins, D. R. | en_ZA |
| dc.contributor.author | Perera, N. | en_ZA |
| dc.contributor.author | Mehtar, S. | en_ZA |
| dc.contributor.author | Tarrant, C. | en_ZA |
| dc.date.accessioned | 2021-10-15T09:15:36Z | |
| dc.date.available | 2021-10-15T09:15:36Z | |
| dc.date.issued | 2019 | |
| dc.description | CITATION: Krockow, E. M., et al. 2019. Balancing the risks to individual and society : a systematic review and synthesis of qualitative research on antibiotic prescribing behaviour in hospitals. Journal of Hospital Infection, 101(4):428-439, doi:10.1016/j.jhin.2018.08.007. | |
| dc.description | The original publication is available at https://www.sciencedirect.com | |
| dc.description.abstract | Background: Antimicrobial resistance is a global health threat, partly driven by inappropriate antibiotic prescriptions for acute medical patients in hospitals. Aim: To provide a systematic review of qualitative research on antibiotic prescribing decisions in hospitals worldwide, including broad-spectrum antibiotic use. Methods: A systematic search of qualitative research on antibiotic prescribing for adult hospital patients published between 2007 and 2017 was conducted. Drawing on the Health Belief Model, a framework synthesis was conducted to assess threat perceptions associated with antimicrobial resistance, and perceived benefits and barriers associated with antibiotic stewardship. Findings: The risk of antimicrobial resistance was generally perceived to be serious, but the abstract and long-term nature of its consequences led physicians to doubt personal susceptibility. While prescribers believed in the benefits of optimizing prescribing, the direct link between over-prescribing and antimicrobial resistance was questioned, and prescribers’ behaviour change was frequently considered futile when fighting the complex problem of antimicrobial resistance. The salience of individual patient risks was a key barrier to more conservative prescribing. Physicians perceived broad-spectrum antibiotics to be effective and low risk; prescribing broad-spectrum antibiotics involved low cognitive demand and enabled physicians to manage patient expectations. Antibiotic prescribing decisions in low-income countries were shaped by a context of heightened uncertainty and risk due to poor microbiology and infection control services. Conclusions: When tackling antimicrobial resistance, the tensions between immediate individual risks and long-term collective risks need to be taken into account. Efforts to reduce diagnostic uncertainty and to change risk perceptions will be critical in shifting practice. | en_ZA |
| dc.description.uri | https://www.sciencedirect.com/science/article/pii/S0195670118304183 | |
| dc.description.version | Publisher's version | |
| dc.format.extent | 12 pages | en_ZA |
| dc.identifier.citation | Krockow, E. M., et al. 2019. Balancing the risks to individual and society : a systematic review and synthesis of qualitative research on antibiotic prescribing behaviour in hospitals. Journal of Hospital Infection, 101(4):428-439, doi:10.1016/j.jhin.2018.08.007 | |
| dc.identifier.issn | 0195-6701 (print) | |
| dc.identifier.other | doi:10.1016/j.jhin.2018.08.007 | |
| dc.identifier.uri | http://hdl.handle.net/10019.1/123235 | |
| dc.language.iso | en_ZA | en_ZA |
| dc.publisher | Elsevier | en_ZA |
| dc.rights.holder | Authors retain copyright | en_ZA |
| dc.subject | Antimicrobial resistance | en_ZA |
| dc.subject | Antibiotics -- Prescribing | en_ZA |
| dc.subject | Qualitative methods (Research) | en_ZA |
| dc.subject | Antimicrobial drugs | en_ZA |
| dc.title | Balancing the risks to individual and society : a systematic review and synthesis of qualitative research on antibiotic prescribing behaviour in hospitals | en_ZA |
| dc.type | Article | en_ZA |