Objective: To evaluate antibiotic prescribing behavior (APB) among physicians with various specialties in five Asian countries.
Design: Survey of antibiotics prescribing behavior in three stages (initial, on-treatment, and de-escalation stages).
Methods: Participants included internists, infectious diseases (ID) specialists, hematologists, intensivists, and surgeons. Participants' characteristics, patterns of APB, and perceptions of antimicrobial stewardship were collected. A multivariate analysis was conducted to evaluate factors associated with appropriate APB.
Results: There were 367 participants. The survey response rate was 82.5% (367/445). For the initial stage, different specialties had different choices for empiric treatment. For the on-treatment stage, if the patient does not respond to empiric treatment, most respondents will step up to broader-spectrum antibiotics (273/367: 74.39%). For the de-escalation stage, the rate of de-escalation was 10%-60% depending on the specialty. Most respondents would de-escalate antibiotics based on guidelines (250/367: 68.12%). De-escalation was mostly reported by ID specialists (66/106: 62.26%). Respondents who reported that they performed laboratory investigations prior to empirical antibiotic prescriptions (aOR = 2.83) were associated with appropriate use, while respondents who reported ID consultation were associated with appropriate antibiotic management for infections not responding to empiric treatment (aOR = 40.87); adherence with national guidelines (aOR = 2.57) was associated with reported successful carbapenem de-escalation.
Conclusion: This study highlights the variation in practices and gaps in appropriate APB on three stages of antibiotic prescription among different specialties. Education on appropriate investigation, partnership with ID specialist, and availability and adherence with national guidelines are critical to help guide appropriate APB among different specialties.
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http://dx.doi.org/10.1017/ash.2023.190 | DOI Listing |
BMC Med Ethics
January 2025
Ethics and Work Research Unit, Institute of Advanced Studies (EPHE), Paris, France.
Aim: To carry out a detailed study of existing positions in the French public of the acceptability of refusing treatment because of alleged futility, and to try to link these to people's age, gender, and religious practice.
Method: 248 lay participants living in southern France were presented with 16 brief vignettes depicting a cancer patient at the end of life who asks his doctor to administer a new cancer treatment he has heard about. Considering that this treatment is futile in the patient's case, the doctor refuses to prescribe it.
J Shoulder Elbow Surg
January 2025
Department of Orthopaedics; University Hospital Cleveland Medical Center, Cleveland, OH, USA.
Background: Recurrent shoulder dislocations often lead to multiple encounters for reduction and eventual surgical stabilization, both of which involve exposure to opioids and potentially increase the risk of chronic opioid exposure. The purpose of our study was to characterize shoulder instability and compare pre- and post-reduction opioid usage in singular dislocators (SD) and recurrent dislocators (RD).
Methods: This retrospective study was performed at a single academic institution using a prospective database.
Rev Esp Anestesiol Reanim (Engl Ed)
January 2025
Servicio de Anestesiología y Reanimación, Hospital General Universitario Gregorio Marañón, Madrid, Spain; Departamento de Medicina Legal, Psiquiatría y Patología, Universidad Complutense, Madrid, Spain. Electronic address:
Introduction: Postoperative pain in ambulatory surgery (AS) continues to be a recurrent problem despite anesthetic and surgical advances. Analgesic prescription and follow-up by patients at home may be a determining factor. Our objective was to evaluate analgesic prescription and its impact on the intensity of postoperative pain at 24 h and 7 days in an AS unit.
View Article and Find Full Text PDFNaunyn Schmiedebergs Arch Pharmacol
January 2025
Department of Organ Transplantation, The Second Affiliated Hospital of Nanchang University, Minde Road No. 1, Nanchang, 330006, Jiangxi, China.
Multimorbidity, therapeutic complexity, and polypharmacy, which greatly increases the risk of drug-drug interactions (DDIs) and adverse medical outcomes, have become important and growing challenges in clinical practice. Statins are frequently prescribed to manage post-transplant dyslipidemia and reduce overall cardiovascular risk in solid organ transplant recipients. This study aimed to determine whether rosuvastatin has significant DDIs with tacrolimus (the first-line immunosuppressant) and to evaluate the risk of hepatotoxicity associated with concomitant therapy.
View Article and Find Full Text PDFScand J Gastroenterol
January 2025
Department of Public Health and Clinical Medicine, Umeå University, Umeå, Sweden.
Objectives: Comorbidity with other conditions is common in functional bowel disorders. We aimed to investigate the prescription patterns of commonly used drugs in patients with irritable bowel syndrome (IBS) and functional unspecific bowel disorder, compared to the general population.
Material And Methods: Prescriptions of commonly used drugs in 2022 were compared between patients and the general population from the same age group and region in Sweden.
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