title: Administration of a survey to evaluate the attitudes of house staff physicians towards antimicrobial resistance and the antimicrobial stewardship programme at a community teaching hospital.
abstract: Antimicrobial stewardship programmes (ASPs) are used in numerous institutions in an effort to promote safe and effective antimicrobial use. The objectives of this study were to (i) assess physicians' perceptions, attitudes and knowledge about antimicrobial use, resistance and the ASP at The Brooklyn Hospital Center (TBHC) and (ii) measure physicians' beliefs and attitudes to the current system of prior authorisation of antimicrobials. A 75-item, anonymous, voluntary, traditional paper and pencil survey was distributed to resident physicians at TBHC. Multiple-choice, 5-point Likert scale and knowledge-based questions were utilised. Of the 261 residents, 129 (49%) completed the survey. The respondents significantly believed that antibiotics are overused more frequently nationally vs. locally [117/129 (91%) vs. 91/129 (71%); P=0.0001]. Although 49% (63/129) felt that other providers overprescribe antibiotics, only 26% (34/129) agreed that they themselves were contributing to the current problem (P=0.0003). Fifty-seven percent of respondents agreed that individual patient care is improved by having an antibiotic approval programme; however, 45% of respondents reported that the antibiotic approval programme limits their autonomy in choosing antibiotics. Compared with surgical residents, medical residents were more likely (33% vs. 13%; P=0.02) to feel that the antibiotic approval programme forced them to choose an inappropriate antibiotic. On the antibiotic knowledge assessment segment of the survey, there was no difference in score when stratified by specialty or years of postgraduate training. Based on the survey results, house staff are supportive of antimicrobial stewardship and feel that the ASP is valuable for patient care.
authors.affiliation: Scripps La Jolla, 9888 Genesee Avenue, La Jolla, CA 92037, USA; The Brooklyn Hospital Center, 121 DeKalb Avenue, Brooklyn, NY 11201, USA.
authors.forename: Veena
authors.initials: V
authors.lastname: Venugopalan
authors.affiliation: Long Island University, 1 University Plaza, Brooklyn, NY 11201, USA.
authors.forename: Nathan
authors.initials: N
authors.lastname: Trustman
authors.affiliation: The Brooklyn Hospital Center, 121 DeKalb Avenue, Brooklyn, NY 11201, USA; SUNY Downstate Medical Center, 450 Clarkson Avenue, Brooklyn, NY 11203, USA.
authors.forename: Nyla
authors.initials: N
authors.lastname: Manning
authors.affiliation: The Brooklyn Hospital Center, 121 DeKalb Avenue, Brooklyn, NY 11201, USA; Lancaster General Hospital, 555 North Duke Street, Lancaster, PA 17602, USA.
authors.forename: Nehal
authors.initials: N
authors.lastname: Hashem
authors.affiliation: The Brooklyn Hospital Center, 121 DeKalb Avenue, Brooklyn, NY 11201, USA.
authors.forename: Leonard
authors.initials: L
authors.lastname: Berkowitz
authors.affiliation: Touro College of Pharmacy, 230 West 125th Street, New York, NY 10027, USA; The Medicines Company, 8 Sylvan Way, Parsippany, NJ 07054, USA. Electronic address: Lkhidayat@gmail.com.
authors.forename: Levita
authors.initials: L
authors.lastname: Hidayat
mesh_terms: D000900:Anti-Bacterial Agents; D000073602:Antimicrobial Stewardship; D001291:Attitude of Health Personnel; D024881:Drug Resistance, Bacterial; D007722:Health Knowledge, Attitudes, Practice; D006784:Hospitals, Teaching; D006801:Humans; D009519:New York City; D010820:Physicians; D010818:Practice Patterns, Physicians'; D011795:Surveys and Questionnaires
chemical_list: D000900:Anti-Bacterial Agents
keywords: Antimicrobial stewardship; Attitudes; Perceptions; Prior authorisation; Survey