Highlights
- •Understanding attitudes to antimicrobial stewardship (AMS) is pivotal to ensuring relevance of local programs.
- •Clinicians within different professions differed in their attitudes toward AMS.
- •Doctors were less interested in AMS education and limits on their prescribing.
- •Nurses were less likely to agree that community antibiotic use contributed to antimicrobial resistance.
- •Pharmacists agreed that expert prescribing advice and feedback was needed.
Background
Effective hospital-wide antimicrobial stewardship (AMS) programs need multidisciplinary
engagement; however, clinicians' attitudes have not been investigated in Thailand
where AMS is in early development. The aim of this study was to explore Thai clinicians'
(doctors, nurses, and pharmacists) perceptions and attitudes toward AMS.
Methods
A paper-based survey was distributed in a 1,000-bed university hospital in Bangkok,
Thailand, between November 9, 2015, and December 21, 2015. A total of 1,087 clinicians
participated: 392 doctors, 613 nurses, and 82 pharmacists.
Results
Most participants agreed that improving antimicrobial prescribing would decrease antimicrobial
resistance (AMR) and should be a priority of hospital policy. Doctors were less likely
to agree with policies that limit antimicrobial prescribing (P < .001) than nurses or pharmacists, and were less likely to be interested in participating
in AMS education than other clinicians (P < .001). Pharmacists indicated higher agreement with the statement, recommending
that a specialist team provide individualized antimicrobial prescribing advice (P < .01) and that feedback improves antimicrobial selection (P < .001). Nurses were less likely to agree that community antibiotic use (P < .001) or patient pressure for antibiotics contribute to AMR (P < .001).
Conclusions
AMS programs are vital to improving antimicrobial use by clinicians. Understanding
clinicians' attitudes and perceptions related to AMS is important to ensure that AMS
programs developed address areas relevant to local clinical needs.
Key Words
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Article info
Publication history
Published online: November 10, 2017
Footnotes
Funding/support: Supported by a PhD scholarship from the Ramathibodi School of Nursing, Faculty of Medicine Ramathibodi Hospital, Mahidol University, Thailand.
Conflicts of interest: None to report.
Identification
Copyright
© 2018 Association for Professionals in Infection Control and Epidemiology, Inc. Published by Elsevier Inc. All rights reserved.
