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Drivers of broad spectrum antibiotic overuse across diverse hospital contexts. A qualitative study of prescribers in the UK, Sri Lanka and South Africa.

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posted on 2021-02-08, 10:04 authored by Carolyn Tarrant, A Colman, D Jenkins, E Chattoe-Brown, Nelun Perera, Shaheen Mehtar, Dilini Nakkawita, Michele Bolscher, Eva Krockow
Antimicrobial stewardship programs focus on reducing overuse of broad-spectrum antibiotics (BSAs), primarily through interventions to change prescribing behavior. This study aims to identify multi-level influences on BSA overuse across diverse high and low income, and public and private, healthcare contexts. Semi-structured interviews were conducted with 46 prescribers from hospitals in the UK, Sri Lanka, and South Africa, including public and private providers. Interviews explored decision making about prescribing BSAs, drivers of the use of BSAs, and benefits of BSAs to various stakeholders, and were analyzed using a constant comparative approach. Analysis identified drivers of BSA overuse at the individual, social and structural levels. Structural drivers of overuse varied significantly across contexts and included: system-level factors generating tensions with stewardship goals; limited material resources within hospitals; and patient poverty, lack of infrastructure and resources in local communities. Antimicrobial stewardship needs to encompass efforts to reduce the reliance on BSAs as a solution to context-specific structural conditions.

History

Citation

Antibiotics 2021, 10(1), 94; https://doi.org/10.3390/antibiotics10010094

Author affiliation

Department of Health Sciences, University of Leicester

Version

  • VoR (Version of Record)

Published in

Antibiotics

Volume

10

Issue

12

Pagination

94

Publisher

MDPI AG

issn

2079-6382

Acceptance date

2021-01-18

Copyright date

2021

Available date

2021-01-19

Language

en

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