دورية أكاديمية
The association of patient complexities with antibiotic ordering.
| العنوان: | The association of patient complexities with antibiotic ordering. |
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| المؤلفون: | Wooten D; Division of Infectious Diseases, Harbor-UCLA Medical Center, and Los Angeles Biomedical Research Institute at Harbor-UCLA Medical Center, Torrance, California.; Division of Infectious Diseases, UCSD Medical Center, San Diego, California., Kahn K; UCLA Clinical and Translational Science Institute, Los Angeles, California.; Division of General Internal Medicine and Health Services Research, David Geffen School of Medicine at UCLA, Los Angeles, and the RAND Corporation, Santa Monica, California., Grein JD; UCLA Clinical and Translational Science Institute, Los Angeles, California.; Department of Hospital Epidemiology, Cedars-Sinai Medical Center, Los Angeles, California., Eells SJ; Division of Infectious Diseases, Harbor-UCLA Medical Center, and Los Angeles Biomedical Research Institute at Harbor-UCLA Medical Center, Torrance, California., Miller LG; Division of Infectious Diseases, Harbor-UCLA Medical Center, and Los Angeles Biomedical Research Institute at Harbor-UCLA Medical Center, Torrance, California.; UCLA Clinical and Translational Science Institute, Los Angeles, California. |
| المصدر: | Journal of hospital medicine [J Hosp Med] 2015 Jul; Vol. 10 (7), pp. 446-52. Date of Electronic Publication: 2015 Apr 15. |
| نوع المنشور: | Journal Article; Multicenter Study |
| اللغة: | English |
| بيانات الدورية: | Publisher: Wiley Country of Publication: United States NLM ID: 101271025 Publication Model: Print-Electronic Cited Medium: Internet ISSN: 1553-5606 (Electronic) Linking ISSN: 15535592 NLM ISO Abbreviation: J Hosp Med Subsets: MEDLINE |
| أسماء مطبوعة: | Publication: 2022- : Hoboken, NJ : Wiley Original Publication: Hoboken, NJ : John Wiley & Sons, 2006- |
| مواضيع طبية MeSH: | Decision Making* , Drug Utilization Review* , Patient Compliance* , Practice Patterns, Physicians'*, Anti-Bacterial Agents/*therapeutic use , Medication Adherence/*statistics & numerical data , Physicians/*standards, Adult ; Female ; Humans ; Male ; Middle Aged |
| مستخلص: | Background: Antibiotic treatment decisions for medically complex patients are complicated, as the risk of undertreatment may be severe, whereas overtreatment may be associated with adverse effects and the emergence of antibiotic resistant pathogens. Objective: To determine the influence of patient complexities on providers' decisions to prescribe antibiotics in 3 common hospital-based clinical vignettes. Design: A physician survey. Setting: Three urban medical centers in Los Angeles County, California. Participants: Hospital-based physicians. Measurements: Physicians were presented 3 clinical vignettes, with variations by patient age, comorbidity burden, functional status, and follow-up, and asked to choose the best antibiotic regimen. We described the association of additional patient complexity on the proportion of guideline-adherent antibiotic choices. Results: In the survey, 28% to 49% of physicians recommended antibiotics that were inconsistent with national guidelines. This percentage increased to 48% to 63% for medically complex patients, defined as those with either older age, high medical comorbidity burden, poor functional status, or limited follow-up after hospital discharge (P < 0.01). Conclusions: In 3 vignettes depicting common clinical scenarios among hospitalized adults, inappropriate antibiotic use was prevalent and occurred more often for patients with medical complexities. Treatment guidelines should consider addressing medically complex patients in the context of infection management. (© 2015 Society of Hospital Medicine.) |
| المشرفين على المادة: | 0 (Anti-Bacterial Agents) |
| تواريخ الأحداث: | Date Created: 20150416 Date Completed: 20160331 Latest Revision: 20150703 |
| رمز التحديث: | 20221213 |
| DOI: | 10.1002/jhm.2367 |
| PMID: | 25873035 |
| قاعدة البيانات: | MEDLINE |
| تدمد: | 1553-5606 |
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| DOI: | 10.1002/jhm.2367 |