Impact of the medical specialty on knowledge regarding multidrug-resistant organisms and strategies toward antimicrobial stewardship

Lebentrau, Steffen; Gilfrich, Christian; Vetterlein, Malte W.; Schumacher, Harald; Spachmann, Philipp; Brookman‐May, Sabine; Fritsche, Hans Martin; Schostak, Martin; Wagenlehner, Florian M. E.; Burger, Maximilian; May, Matthias

doi:10.1007/s11255-017-1603-1

Cited by 27 publications

(50 citation statements)

References 14 publications

(34 reference statements)

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“…Antibiotic stewardship programs include prospective audits with intervention and feedback, and formulary restriction and pre-authorization [16]. Although Antibiotic stewardship programs have been proven to be effective in reducing the unnecessary use of antibiotics [16], even today, the awareness and knowledge regarding this problem is scarce, and there is substantial need for advanced training, regardless of medical specialty [17]. Even in specialized SCI rehabilitation centers, overtreatment of UTI is not uncommon [18].…”

Section: Discussionmentioning

confidence: 99%

Treatment of Complicated Urinary Tract Infections in Individuals with Chronic Neurogenic Lower Urinary Tract Dysfunction: Are Antibiotics Mandatory?

2018

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Introduction: Urinary tract infections (UTI) in patients with neurogenic lower urinary tract dysfunction (NLUTD) are defined as complicated UTI requiring antibiotic treatment. As the emergence of multiresistant strains is a serious problem, we assessed the feasibility of nonantibiotic treatment of UTI in patients with NLUTD. Materials and Methods: In a prospective study evaluating the usefulness of UTI prophylaxis, participants could opt for either antibiotic or nonantibiotic treatment of breakthrough UTI. If either symptoms persisted for 48 h or a febrile UTI occurred, antibiotic treatment based on microbiological testing was mandatory. Treatment efficacy, complications, and emergency hospital visits were assessed. Results: Within the observation period (1 year), the 25 participants developed 206 UTI. Seven febrile UTI required immediate antibiotic treatment. Of the remaining 199 UTI, patients chose antibiotic treatment in 104 events, whereas in 95 events, patients chose either nonantibiotic interventions (n = 80) or no treatment at all (n = 15). Success rates were 78.8% for antibiotic treatment, 67.5% with nonantibiotic treatments, and 26% without therapy. Of the 7 patients with initially febrile UTI, 2 required hospitalization due to septicemia. Conclusions: Nonantibiotic treatment seems to be a feasible alternative to antibiotic therapy in patients with complicated UTI as well, provided there is no fever.

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Section: Discussionmentioning

confidence: 99%

Treatment of Complicated Urinary Tract Infections in Individuals with Chronic Neurogenic Lower Urinary Tract Dysfunction: Are Antibiotics Mandatory?

2018

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“…Nonetheless, our return rate of 54% is >10% higher than achieved for the previously conducted MR2 surveys of urologists, surgeons, gynecologists, and internists. 4,5 Furthermore, despite different return rates, the results of the participating hospitals displayed homogeneity in separate analyses (data not shown), and our multivariate analyses were adjusted by the status of the hospital (ie, university hospitals vs nonuniversity hospitals). In addition, only larger German hospitals were evaluated, which might not be representative of the entire national clinical reality.…”

Section: To the Editormentioning

confidence: 92%

An anesthesia perspective on surgical antibiotic prophylaxis: Results of a comprehensive infectiology survey study in German hospitals

Mutlak

Maurer

Zacharowski

et al. 2019

American Journal of Infection Control

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“…In 2017, this version of the MR2-Survey was adapted to specifically include anesthetic problems. [19][20][21][22][23] Besides five demographic questions, the query contained items on the participant's self-confidence (n = 6, Likert scale; 1 = very unconfident, 2 = unconfident, 3 = confident, 4 = very confident), selfrated knowledge (n = 16, Likert scale; 1 = no knowledge, 2 = little knowledge, 3 = knowledge, 4 = full knowledge), and objective knowledge (n = 5, multiple choice) regarding multi-resistant pathogens and the rational use of antibiotics. In line with prior research about self-confidence in a medical environment, four-point Likert-Scales were chosen so that participants had to decide between the positive and negative axes [24,25].…”

Section: Development Of the Surveymentioning

confidence: 99%

The association of the anesthesiologist’s academic and educational status with self-confidence, self-rated knowledge and objective knowledge in rational antibiotic application

et al. 2020

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Objective: This study aimed to investigate the association of anesthetists' academic and educational status with selfconfidence, self-rated knowledge and objective knowledge about rational antibiotic application. Therefore, anesthetists in Germany were asked about their self-confidence, self-rated knowledge and objective knowledge on antibiotic therapy via the Multiinstitutional Reconnaissance of practice with Multiresistant bacteria (MR2) survey. Other analysis from the survey have been published elsewhere, before. Results: 361 (52.8%) questionnaires were completed by specialists and built the study group. In overall analysis the Certification in Intensive Care (CIC) was significantly associated with self-confidence (p < 0.001), self-rated knowledge (p < 0.001) and objective knowledge (p = 0.029) about antibiotic prescription. Senior consultant status was linked to self-confidence (p < 0.001) and self-rated knowledge (p = 0.005) but not objective knowledge. Likewise, working on Intensive Care Unit (ICU) during the last 12 months was significantly associated with self-rated knowledge and selfconfidence (all p < 0.001). In a logistic regression model, senior consultant status was not associated with any tested influence factor. This analysis unveiled that CIC and working on ICU were more associated with anesthesiologists' self-confidence and self-rated knowledge than senior consultant status. However, neither of the characteristics was thoroughly associated with objective knowledge.

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Impact of the medical specialty on knowledge regarding multidrug-resistant organisms and strategies toward antimicrobial stewardship

Abstract: There is substantial need for advanced training regarding MDRO and antibiotic stewardship, regardless of medical specialty.

Cited by 27 publications

References 14 publications

Treatment of Complicated Urinary Tract Infections in Individuals with Chronic Neurogenic Lower Urinary Tract Dysfunction: Are Antibiotics Mandatory?

Treatment of Complicated Urinary Tract Infections in Individuals with Chronic Neurogenic Lower Urinary Tract Dysfunction: Are Antibiotics Mandatory?

An anesthesia perspective on surgical antibiotic prophylaxis: Results of a comprehensive infectiology survey study in German hospitals

The association of the anesthesiologist’s academic and educational status with self-confidence, self-rated knowledge and objective knowledge in rational antibiotic application

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