The DOI matches its Crossref record; 41 of the 41 references it cites were found in a registry or an index.
Understanding the Determinants of Antimicrobial Prescribing Within Hospitals: The Role of "Prescribing Etiquette"
Open accessAbstract
BACKGROUND: There is limited knowledge of the key determinants of antimicrobial prescribing behavior (APB) in hospitals. An understanding of these determinants is required for the successful design, adoption, and implementation of quality improvement interventions in antimicrobial stewardship programs. METHODS: Qualitative semistructured interviews were conducted with doctors (n = 10), pharmacists (n = 10), and nurses and midwives (n = 19) in 4 hospitals in London. Interviews were conducted until thematic saturation was reached. Thematic analysis was applied to the data to identify the key determinants of antimicrobial prescribing behaviors. RESULTS: The APB of healthcare professionals is governed by a set of cultural rules. Antimicrobial prescribing is performed in an environment where the behavior of clinical leaders or seniors influences practice of junior doctors. Senior doctors consider themselves exempt from following policy and practice within a culture of perceived autonomous decision making that relies more on personal knowledge and experience than formal policy. Prescribers identify with the clinical groups in which they work and adjust their APB according to the prevailing practice within these groups. A culture of "noninterference" in the antimicrobial prescribing practice of peers prevents intervention into prescribing of colleagues. These sets of cultural rules demonstrate the existence of a "prescribing etiquette," which dominates the APB of healthcare professionals. Prescribing etiquette creates an environment in which professional hierarchy and clinical groups act as key determinants of APB. CONCLUSIONS: To influence the antimicrobial prescribing of individual healthcare professionals, interventions need to address prescribing etiquette and use clinical leadership within existing clinical groups to influence practice.
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Self-citationFrench, S. D., Green, S. E., O’Connor, D. A., McKenzie, J. E., Francis, J. J., Michie, S., Buchbinder, R., Schattner, P., Spike, N., & Grimshaw, J. M. (2012) · Implementation Science · doi:10.1186/1748-5908-7-38 · Cited by 1,338
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Cited by
Charani, E., Ahmad, R., Rawson, T. M., Castro-Sanchèz, E., Tarrant, C., & Holmes, A. H. (2019) · Clinical Infectious Diseases · doi:10.1093/cid/ciy844 · Cited by 152
Self-citationCharani, E., Smith, I., Skodvin, B., Perozziello, A., Lucet, J.-C., Lescure, F.-X., Birgand, G., Poda, A., Ahmad, R., Singh, S., et al. (2019) · PLOS ONE · doi:10.1371/journal.pone.0209847 · Cited by 139
Self-citationMenz, B. D., Charani, E., Gordon, D. L., Leather, A. J., Moonesinghe, S. R., & Phillips, C. J. (2021) · Infection and Drug Resistance · doi:10.2147/idr.s319780 · Cited by 118
Self-citationAntibiotic prescribing in long-term care facilities: a qualitative, multidisciplinary investigation
Fleming, A., Bradley, C., Cullinan, S., & Byrne, S. (2014) · BMJ Open · doi:10.1136/bmjopen-2014-006442 · Cited by 117
Understanding antibiotic decision making in surgery—a qualitative analysis
Charani, E., Tarrant, C., Moorthy, K., Sevdalis, N., Brennan, L., & Holmes, A. H. (2017) · Clinical Microbiology and Infection · doi:10.1016/j.cmi.2017.03.013 · Cited by 101
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Metadata
- Authors
- Charani, E., Castro-Sanchez, E., Sevdalis, N., Kyratsis, Y., Drumright, L., Shah, N., & Holmes, A.
- Venue
- Clinical Infectious Diseases
- Publisher
- Oxford University Press (OUP)
- Published
- 2013-04-09
- Volume
- 57
- Issue
- 2
- Pages
- 188-196
- ISSN
- 1058-4838 (ISSN-L)
- 1537-6591
- OpenAlex
- W2120201964
- Cited by
- 455
- References
- 41
- FWCI
- 25.00
- Type
- journal article
- Language
- en
- Open access
- hybrid
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