Impact of the medical specialty on knowledge regarding multidrug-resistant organisms and strategies toward antimicrobial stewardship
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Impact of the medical specialty on knowledge regarding multidrug-resistant organisms and strategies toward antimicrobial stewardship. / Lebentrau, Steffen; Gilfrich, Christian; Vetterlein, Malte W; Schumacher, Harald; Spachmann, Philipp J; Brookman-May, Sabine D; Fritsche, Hans-Martin; Schostak, Martin; Wagenlehner, Florian M; Burger, Maximilian; May, Matthias; MR2 study group.
in: INT UROL NEPHROL, Jahrgang 49, Nr. 8, 08.2017, S. 1311-1318.Publikationen: SCORING: Beitrag in Fachzeitschrift/Zeitung › SCORING: Zeitschriftenaufsatz › Forschung › Begutachtung
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TY - JOUR
T1 - Impact of the medical specialty on knowledge regarding multidrug-resistant organisms and strategies toward antimicrobial stewardship
AU - Lebentrau, Steffen
AU - Gilfrich, Christian
AU - Vetterlein, Malte W
AU - Schumacher, Harald
AU - Spachmann, Philipp J
AU - Brookman-May, Sabine D
AU - Fritsche, Hans-Martin
AU - Schostak, Martin
AU - Wagenlehner, Florian M
AU - Burger, Maximilian
AU - May, Matthias
AU - MR2 study group
PY - 2017/8
Y1 - 2017/8
N2 - PURPOSE: Evidence is scarce on subject-specific knowledge of multidrug-resistant organisms and rational use of antibiotics. We aimed at evaluating attitude, perception, and knowledge about multidrug-resistant organisms (MDRO) and antibiotic prescribing among urologists versus other medical specialties.METHODS: Within the MR2-study (Multiinstitutional Reconnaissance of practice with MultiResistant bacteria), a questionnaire was conducted targeting general surgeons, internists, gynecologists, and urologists in 18 German hospitals. The influence of medical specialty on predetermined endpoints was assessed by multivariable logistic regression models.RESULTS: With 456 evaluable questionnaires, the response rate was 43% (456/1061). Within seven workdays prior to survey, urologists prescribed antibiotics to >5 patients more often than non-urologists (50.7 vs. 24.3%; p < 0.001). Urologists were more confident regarding dosage, frequency, and duration of antibiotic treatment (p = 0.038) as well as in interpreting antibiograms (p < 0.001). Both urologists and non-urologists had poor knowledge about antibiotic stewardship. Urologists were more confident regarding local resistance patterns (p < 0.001). However, local rates of ciprofloxacin-resistant E. coli strains were correctly categorized by only 36.3 and 31.2% of urologists and non-urologists, respectively (p = 0.168). Compared to non-urologists, urologists more often acknowledged the use of broad-spectrum antibiotic agents as a problem, potentially resulting in increased resistance pattern (p = 0.036). Conversely, 31.5 and 30.7% of urologists and non-urologists (p = 0.424), respectively, would prescribe broad-spectrum antibiotics to a female patient with an uncomplicated urinary tract infection. Urologists did not attend more training courses regarding multidrug-resistance or antibiotic prescribing and did not perceive a better quality of discharge letters regarding MDRO.CONCLUSIONS: There is substantial need for advanced training regarding MDRO and antibiotic stewardship, regardless of medical specialty.
AB - PURPOSE: Evidence is scarce on subject-specific knowledge of multidrug-resistant organisms and rational use of antibiotics. We aimed at evaluating attitude, perception, and knowledge about multidrug-resistant organisms (MDRO) and antibiotic prescribing among urologists versus other medical specialties.METHODS: Within the MR2-study (Multiinstitutional Reconnaissance of practice with MultiResistant bacteria), a questionnaire was conducted targeting general surgeons, internists, gynecologists, and urologists in 18 German hospitals. The influence of medical specialty on predetermined endpoints was assessed by multivariable logistic regression models.RESULTS: With 456 evaluable questionnaires, the response rate was 43% (456/1061). Within seven workdays prior to survey, urologists prescribed antibiotics to >5 patients more often than non-urologists (50.7 vs. 24.3%; p < 0.001). Urologists were more confident regarding dosage, frequency, and duration of antibiotic treatment (p = 0.038) as well as in interpreting antibiograms (p < 0.001). Both urologists and non-urologists had poor knowledge about antibiotic stewardship. Urologists were more confident regarding local resistance patterns (p < 0.001). However, local rates of ciprofloxacin-resistant E. coli strains were correctly categorized by only 36.3 and 31.2% of urologists and non-urologists, respectively (p = 0.168). Compared to non-urologists, urologists more often acknowledged the use of broad-spectrum antibiotic agents as a problem, potentially resulting in increased resistance pattern (p = 0.036). Conversely, 31.5 and 30.7% of urologists and non-urologists (p = 0.424), respectively, would prescribe broad-spectrum antibiotics to a female patient with an uncomplicated urinary tract infection. Urologists did not attend more training courses regarding multidrug-resistance or antibiotic prescribing and did not perceive a better quality of discharge letters regarding MDRO.CONCLUSIONS: There is substantial need for advanced training regarding MDRO and antibiotic stewardship, regardless of medical specialty.
KW - Journal Article
U2 - 10.1007/s11255-017-1603-1
DO - 10.1007/s11255-017-1603-1
M3 - SCORING: Journal article
C2 - 28432607
VL - 49
SP - 1311
EP - 1318
JO - INT UROL NEPHROL
JF - INT UROL NEPHROL
SN - 0301-1623
IS - 8
ER -
