title: Comparison of the appropriate use of antibiotics based on clinical guidelines between physicians in-training versus practicing physicians.
abstract: The inappropriate antibiotic can lead to serious negative effects on health. This has been the cause of emergence of multidrug resistant bacteria and the need of surveillance of antibiotics in the inpatient setting. An adequate knowledge on which and when prescribing antibiotics is essential to avoid these issues. Because of this problems, guidelines have been developed to educate and control the misuse and abuse of antibiotics and improve clinical outcomes. We evaluated the medical knowledge, medical trends, and the effectiveness of professional interventions among Puerto Rico physicians in promoting prudent antibiotic prescribing. A comparative study was performed using a questionnaire about prudent antibiotic use in common infections seen in Puerto Rico. It was distributed among the major three internal medicine training programs at San Juan, internal medicine physicians and general physicians. General physicians failed to treat adequately asymptomatic bacteriuria, and overall failed in treating other common conditions when compared with residents and internal medicine physicians. One of our questions was related to the treatment of Extended Spectrum Beta Lactamase (ESBL) positive Escherichia coli (E. coli) and more than 50% of the surveyed failed to answer the question correctly. Conditions as viral respiratory tract infections and community acquired pneumonia had the higher correctly answered questions among the groups. Our questionnaire demonstrates that guidelines have to reach the education among the general physician population to decrease the overuse of inadequate antibiotics, and education should be strengthen on those internal medicine physicians that have already completed formal training.
authors.affiliation: Internal Medicine Department, San Juan City Hospital, San Juan Puerto Rico. frank1298@hotmail.com
authors.forename: Francisco
authors.initials: F
authors.lastname: Fernández González
authors.forename: Javieth
authors.initials: J
authors.lastname: Detrés
authors.forename: Pedro
authors.initials: P
authors.lastname: Torrellas
authors.forename: Carmen R
authors.initials: CR
authors.lastname: Balleste
mesh_terms: D000328:Adult; D000900:Anti-Bacterial Agents / Q000627:therapeutic use*; D024901:Drug Resistance, Multiple, Bacterial; D004363:Drug Utilization; D004926:Escherichia coli / Q000187:drug effects; D005260:Female; D058006:General Practice / Q000193:education; D058005:General Practitioners / Q000193:education / Q000706:statistics & numerical data; D019983:Guideline Adherence / Q000706:statistics & numerical data*; D006784:Hospitals, Teaching / Q000706:statistics & numerical data; D006786:Hospitals, Urban / Q000706:statistics & numerical data; D006787:Hospitals, Veterans / Q000706:statistics & numerical data; D006801:Humans; D057970:Inappropriate Prescribing / Q000706:statistics & numerical data*; D007388:Internal Medicine / Q000193:education*; D007396:Internship and Residency; D008297:Male; D008505:Medical Staff, Hospital / Q000706:statistics & numerical data; D010820:Physicians / Q000145:classification / Q000706:statistics & numerical data*; D017410:Practice Guidelines as Topic; D010818:Practice Patterns, Physicians' / Q000706:statistics & numerical data*; D011647:Puerto Rico; D011795:Surveys and Questionnaires; D018440:beta-Lactam Resistance
chemical_list: D000900:Anti-Bacterial Agents