Impact of antimicrobial drug restrictions on doctors? behaviors

Background/aim: Broad-spectrum antibiotics have become available for use only with the approval of infectious disease specialists (IDSs) since 2003 in Turkey. This study aimed to analyze the tendencies of doctors who are not disease specialists (non-IDSs) towards the restriction of antibiotics. Materials and methods: A questionnaire form was prepared, which included a total of 22 questions about the impact of antibiotic restriction (AR) policy, the role of IDSs in the restriction, and the perception of this change in antibiotic consumption. The questionnaire was completed by each participating physician. Results: A total of 1906 specialists from 20 cities in Turkey participated in the study. Of those who participated, 1271 (67.5%) had ≤5 years of occupational experience (junior specialists = JSs) and 942 (49.4%) of them were physicians. Specialists having >5 years of occupational experience in their branch expressed that they followed the antibiotic guidelines more strictly than the JSs (P < 0.05) and 755 of physicians (88%) and 720 of surgeons (84.6%) thought that the AR policy was necessary and useful (P < 0.05). Conclusion: This study indicated that the AR policy was supported by most of the specialists. Physicians supported this restriction policy more so than surgeons did.

PDF

___

1. Allerberger F, Gareis R, Jindrak V, Struelens MJ. Antibiotic stewardship implementation in the EU: the way forward. Expert Rev Anti Infect Ther 2009; 7: 11751183.
2. MacDougall C, Polk RE. Antimicrobial stewardship programs in health care systems. Clin Microbiol Rev 2005; 18: 638656.
3. Karabay O, Hosoglu S. Increased antimicrobial consumption following reimbursement reform in Turkey. J Antimicrob Chemother 2008; 61: 11691171.
4. Karabay O, Özdemir D, Güçlü E, Yıldırım M, Ince N, Kucukbayrak A, Çakır S, Gülenç M, İnce M, Demirli K. Attitudes and behaviors of family physicians regarding use of antibiotics. J Microbiol Infect Dis 2011; 1: 5357.
5. Price D. Impact of antibiotic restrictions: the physicians perspective. Clin Microbiol Infect 2006; 12 (Suppl. 5): S39.
6. Karabay O. Rights and the wrongs in antibiotic usage ANKEM Derg 2013; 27 (Suppl. 2): 165167.
7. Alpar R. Uygulamalı İstatistik ve Geçerlik Güvenirlik. Ankara, Turkey: Detay Yayıncılık; 2012 (in Turkish).
8. Özdamar, K. Paket Programlar İle İstatistiksel Veri Analizi. Ankara, Turkey: Nisan Kitabevi; 2013 (in Turkish).
9. Moody J, Cosgrove SE, Olmsted R, Septimus E, Aureden K, Oriola S, Patel GW, Trivedi KK. Antimicrobial stewardship: a collaborative partnership between infection preventionists and health care epidemiologists. Am J Infect Control 2012; 40: 9495.
10. Fukuda K. Antimicrobial drug resistance threat: our duty towards future generations. East Mediterr Health J 2013; 19: 399.
11. Zhang HX, Li X, Huo HQ, Liang P, Zhang JP, Ge WH. Pharmacist interventions for prophylactic antibiotic use in urological in patients undergoing clean or clean-contaminated operations in a Chinese hospital. PLoS One 2014; 25; 9:e88971.
12. Işıkgöz Taşbakan M, Pullukçu H, Siapahi OR, Yamazhan T, Arda B, Ulusoy S. A pooled analysis of the resistance patterns of Escherichia coli strains isolated from urine cultures in Turkey: a comparison of the periods 1997-2001 and 2002-2007. Turk J Med Sci 2011; 41: 557564.
13. Dellinger RP, Levy MM, Rhodes A, Annane D, Gerlach H, Opal SM, Sevransky JE, Sprung CL, Douglas IS, Jaeschke R et al. Surviving sepsis campaign guidelines committee including the pediatric subgroup. Surviving Sepsis Campaign: international guidelines for management of severe sepsis and septic shock, 2012. Intensive Care Med 2013; 39: 165228.
14. İnan A, Dağlı Ö, Akçay SŞ, Engin DÖ, Karagül E, Özyürek SÇ. Antibiotic use and cost in a teaching hospital in İstanbul. J Microbiol Infect Dis 2011; 1: 128133.