Understanding the role of antibiotic-associated adverse events in influencing antibiotic decision-making
Abstract Objective: To (1) understand the role of antibiotic-associated adverse events (ABX-AEs) on antibiotic decision-making, (2) understand clinician preferences for ABX-AE feedback, and (3) identify ABX-AEs of greatest clinical concern. Design: Focus groups. Setting: Academic medical cente...
| Main Authors: | , , , , , , , , , |
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| Format: | Article |
| Language: | English |
| Published: |
Cambridge University Press
2024-01-01
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| Series: | Antimicrobial Stewardship & Healthcare Epidemiology |
| Online Access: | https://www.cambridge.org/core/product/identifier/S2732494X24000020/type/journal_article |
| _version_ | 1797338670946058240 |
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| author | Jerald P. Cherian Taylor N. Helsel George F. Jones Zunaira Virk Alejandra Salinas Suzanne M. Grieb Eili Y. Klein Pranita D. Tamma Sara E. Cosgrove for the Centers for Disease Control and Prevention’s Prevention Epicenters Program |
| author_facet | Jerald P. Cherian Taylor N. Helsel George F. Jones Zunaira Virk Alejandra Salinas Suzanne M. Grieb Eili Y. Klein Pranita D. Tamma Sara E. Cosgrove for the Centers for Disease Control and Prevention’s Prevention Epicenters Program |
| author_sort | Jerald P. Cherian |
| collection | DOAJ |
| description |
Abstract
Objective:
To (1) understand the role of antibiotic-associated adverse events (ABX-AEs) on antibiotic decision-making, (2) understand clinician preferences for ABX-AE feedback, and (3) identify ABX-AEs of greatest clinical concern.
Design:
Focus groups.
Setting:
Academic medical center.
Participants:
Medical and surgical house staff, attending physicians, and advanced practice practitioners.
Methods:
Focus groups were conducted from May 2022 to December 2022. Participants discussed the role of ABX-AEs in antibiotic decision-making and feedback preferences and evaluated the prespecified categorization of ABX-AEs based on degree of clinical concern. Thematic analysis was conducted using inductive coding.
Results:
Four focus groups were conducted (n = 15). Six themes were identified. (1) ABX-AE risks during initial prescribing influence the antibiotic prescribed rather than the decision of whether to prescribe. (2) The occurrence of an ABX-AE leads to reassessment of the clinical indication for antibiotic therapy. (3) The impact of an ABX-AE on other management decisions is as important as the direct harm of the ABX-AE. (4) ABX-AEs may be overlooked because of limited feedback regarding the occurrence of ABX-AEs. (5) Clinicians are receptive to feedback regarding ABX-AEs but are concerned about it being punitive. (6) Feedback must be curated to prevent clinicians from being overwhelmed with data. Clinicians generally agreed with the prespecified categorizations of ABX-AEs by degree of clinical concern.
Conclusions:
The themes identified and assessment of ABX-AEs of greatest clinical concern may inform antibiotic stewardship initiatives that incorporate reporting of ABX-AEs as a strategy to reduce unnecessary antibiotic use.
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| first_indexed | 2024-03-08T09:33:40Z |
| format | Article |
| id | doaj.art-375fd3b397c74c529deb2adabd7e6f7f |
| institution | Directory Open Access Journal |
| issn | 2732-494X |
| language | English |
| last_indexed | 2024-03-08T09:33:40Z |
| publishDate | 2024-01-01 |
| publisher | Cambridge University Press |
| record_format | Article |
| series | Antimicrobial Stewardship & Healthcare Epidemiology |
| spelling | doaj.art-375fd3b397c74c529deb2adabd7e6f7f2024-01-30T12:51:52ZengCambridge University PressAntimicrobial Stewardship & Healthcare Epidemiology2732-494X2024-01-01410.1017/ash.2024.2Understanding the role of antibiotic-associated adverse events in influencing antibiotic decision-makingJerald P. Cherian0https://orcid.org/0000-0001-5795-7311Taylor N. Helsel1George F. Jones2Zunaira Virk3Alejandra Salinas4https://orcid.org/0000-0002-5673-5028Suzanne M. Grieb5https://orcid.org/0000-0001-9971-4115Eili Y. Klein6https://orcid.org/0000-0002-1304-5289Pranita D. Tamma7Sara E. Cosgrove8for the Centers for Disease Control and Prevention’s Prevention Epicenters ProgramDepartment of Medicine, Division of Infectious Diseases, Johns Hopkins University School of Medicine, Baltimore, MD, USADepartment of Medicine, Division of Infectious Diseases, Johns Hopkins University School of Medicine, Baltimore, MD, USADepartment of Medicine, Division of Infectious Diseases, Johns Hopkins University School of Medicine, Baltimore, MD, USADepartment of Medicine, Division of Infectious Diseases, Johns Hopkins University School of Medicine, Baltimore, MD, USADepartment of Medicine, Division of Infectious Diseases, Johns Hopkins University School of Medicine, Baltimore, MD, USADepartment of Pediatrics, Center for Child and Community Health Research, Johns Hopkins University School of Medicine, Baltimore, MD, USADepartment of Emergency Medicine, Johns Hopkins University School of Medicine, Baltimore, MD, USADepartment of Pediatrics, Division of Infectious Diseases, Johns Hopkins University School of Medicine, Baltimore, MD, USADepartment of Medicine, Division of Infectious Diseases, Johns Hopkins University School of Medicine, Baltimore, MD, USA Abstract Objective: To (1) understand the role of antibiotic-associated adverse events (ABX-AEs) on antibiotic decision-making, (2) understand clinician preferences for ABX-AE feedback, and (3) identify ABX-AEs of greatest clinical concern. Design: Focus groups. Setting: Academic medical center. Participants: Medical and surgical house staff, attending physicians, and advanced practice practitioners. Methods: Focus groups were conducted from May 2022 to December 2022. Participants discussed the role of ABX-AEs in antibiotic decision-making and feedback preferences and evaluated the prespecified categorization of ABX-AEs based on degree of clinical concern. Thematic analysis was conducted using inductive coding. Results: Four focus groups were conducted (n = 15). Six themes were identified. (1) ABX-AE risks during initial prescribing influence the antibiotic prescribed rather than the decision of whether to prescribe. (2) The occurrence of an ABX-AE leads to reassessment of the clinical indication for antibiotic therapy. (3) The impact of an ABX-AE on other management decisions is as important as the direct harm of the ABX-AE. (4) ABX-AEs may be overlooked because of limited feedback regarding the occurrence of ABX-AEs. (5) Clinicians are receptive to feedback regarding ABX-AEs but are concerned about it being punitive. (6) Feedback must be curated to prevent clinicians from being overwhelmed with data. Clinicians generally agreed with the prespecified categorizations of ABX-AEs by degree of clinical concern. Conclusions: The themes identified and assessment of ABX-AEs of greatest clinical concern may inform antibiotic stewardship initiatives that incorporate reporting of ABX-AEs as a strategy to reduce unnecessary antibiotic use. https://www.cambridge.org/core/product/identifier/S2732494X24000020/type/journal_article |
| spellingShingle | Jerald P. Cherian Taylor N. Helsel George F. Jones Zunaira Virk Alejandra Salinas Suzanne M. Grieb Eili Y. Klein Pranita D. Tamma Sara E. Cosgrove for the Centers for Disease Control and Prevention’s Prevention Epicenters Program Understanding the role of antibiotic-associated adverse events in influencing antibiotic decision-making Antimicrobial Stewardship & Healthcare Epidemiology |
| title | Understanding the role of antibiotic-associated adverse events in influencing antibiotic decision-making |
| title_full | Understanding the role of antibiotic-associated adverse events in influencing antibiotic decision-making |
| title_fullStr | Understanding the role of antibiotic-associated adverse events in influencing antibiotic decision-making |
| title_full_unstemmed | Understanding the role of antibiotic-associated adverse events in influencing antibiotic decision-making |
| title_short | Understanding the role of antibiotic-associated adverse events in influencing antibiotic decision-making |
| title_sort | understanding the role of antibiotic associated adverse events in influencing antibiotic decision making |
| url | https://www.cambridge.org/core/product/identifier/S2732494X24000020/type/journal_article |
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