title: Physician knowledge and adherence to prescribing antibiotic prophylaxis for sickle cell disease.
abstract: OBJECTIVE
  The purpose of this research was to examine how physician characteristics were associated with: (i). physician knowledge of and adherence to sickle cell guidelines; and (ii). the types of educational programs about sickle cell disease desired by physicians.
  
  
  METHODS
  A survey was developed to assess the research objective. After the survey was pre-tested and an institutional review board exemption was obtained, it was sent to a systematic random sample of 375 pediatricians and all 125 practicing hematologists in North Carolina. They were asked to answer a six-item knowledge test relating to the antibiotic prophylaxis guidelines.
  
  
  RESULTS
  The response rate was 57%, of which 61% were pediatricians. Over half (56%) were in a practice with at least one pediatric sickle cell patient. Fifty-nine percent of physicians answered five or more questions correctly on the knowledge test. The question most physicians answered correctly (97%) pertained to the necessity of antibiotics for children with sickle cell disease. The question most frequently answered incorrectly (62%) pertained to prescribing antibiotics to a child with unconfirmed sickle cell disease. Logistic regression results indicated that the number of sickle cell patients seen in practice influenced the number of questions answered correctly. Sixty-six percent of physicians prescribed prophylactic antibiotics for 100% of their patients with sickle cell disease and therefore were 100% adherent. Eighty-one percent of pediatricians compared with 12% of hematologists were 100% adherent in prescribing antibiotics. Hematologists and those practicing at a medical school or university were less likely to be 100% adherent in prescribing antibiotic prophylaxis.
  
  
  CONCLUSIONS
  The majority of physicians surveyed were relatively knowledgeable about sickle cell guidelines, however there may be a need for continuing education programs that focus on the issues of prescribing antibiotics to a child with unconfirmed sickle cell disease and penicillin dosage.
authors.affiliation: University of North Carolina School of Pharmacy and School of Public Health, University of North Carolina, Chapel Hill, NC 27599-7630, USA. keele_wurst@unc.edu
authors.forename: Keele E
authors.initials: KE
authors.lastname: Wurst
authors.forename: Betsy L
authors.initials: BL
authors.lastname: Sleath
mesh_terms: D000328:Adult; D000368:Aged; D000755:Anemia, Sickle Cell / Q000188:drug therapy*; D019072:Antibiotic Prophylaxis / Q000706:statistics & numerical data*; D003430:Cross-Sectional Studies; D003625:Data Collection; D005260:Female; D019983:Guideline Adherence; D007722:Health Knowledge, Attitudes, Practice; D006302:Health Services Research; D006801:Humans; D008297:Male; D008875:Middle Aged; D009657:North Carolina; D010818:Practice Patterns, Physicians'