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Title: | Defensive medicine among antibiotic stewards: the international ESCMID AntibioLegalMap survey | Authors: | Tebano, Gianpiero Dyar, Oliver J. Beovic, Bojana BERAUD, Guillaume Thilly, Nathalie Pulcini, Celine |
Issue Date: | 2018 | Publisher: | OXFORD UNIV PRESS | Source: | JOURNAL OF ANTIMICROBIAL CHEMOTHERAPY, 73(7), p. 1989-1996 | Abstract: | Objectives: To investigate fear of legal claims and defensive behaviours among specialists in infectious diseases (ID) and clinical microbiology (CM) and to identify associated demographic and professional characteristics. Methods: AntibioLegalMap was an international cross-sectional internet-based survey targeting specialists in ID and CM. Three variables were explored: fear of legal liability in antibiotic prescribing/advising on antibiotic prescription; defensive behaviours in antibiotic prescribing; and defensive behaviours in advising. A multivariable logistic regression analysis was performed to identify factors significantly associated with each of the three variables. Results: Eight hundred and thirty individuals from 74 countries participated. Only 0.4% (3/779) had any kind of condemnation for malpractice related to antibiotic prescription. Concerning the fear of liability, 21.2% (164/774) of respondents said they never worried, 45.1% (349/774) sometimes worried and 28.6% (221/774) frequently worried when prescribing/advising on antibiotic prescription. Being female, younger than or equal to 35 years and aware of previous cases of litigation were independently associated with fear. Most respondents (85.0%, 525/618) reported some defensive behaviour in antibiotic prescribing. These behaviours were independently associated with being younger than or equal to 35 years and sometimes or often worried about liability. Similarly, 76.4% (505/661) reported defensive behaviours in advising. These behaviours were associated with being sometimes or often worried about liability. The preferred measures to reduce fear and defensive behaviours were having local guidelines and sharing decisions through teamwork. Conclusions: A significant proportion of specialists in ID and CM reported some form of defensive behaviour in prescribing or advising to prescribe antibiotics. Defensive medicine should be considered when implementing antibiotic stewardship programmes. | Notes: | [Tebano, Gianpiero; Thilly, Nathalie; Pulcini, Celine] Univ Lorraine, EA APEMAC 4360, Nancy, France. [Dyar, Oliver J.] Karolinska Inst, Dept Publ Hlth Sci, Global Hlth Hlth Syst & Policy, Stockholm, Sweden. [Beovic, Bojana] Univ Med Ctr Ljubljana, Ljubljana, Slovenia. [Beovic, Bojana] Univ Ljubljana, Fac Med, Ljubljana, Slovenia. [Beraud, Guillaume] Univ Laval, CHU Quebec, Ctr Rech, Hop St Sacrement, Chemin St Foy, Quebec City, PQ, Canada. [Beraud, Guillaume] CHU Poitiers, Med Interne & Malad Infect, Poitiers, France. [Beraud, Guillaume] Hasselt Univ, Interuniv Inst Biostat & Stat Bioinformat, Censtat, Hasselt, Belgium. [Thilly, Nathalie] CHRU Nancy, Plateforme Aide Rech Clin, Nancy, France. [Pulcini, Celine] CHRU Nancy, Serv Malad Infect & Trop, Nancy, France. | Keywords: | antibiotics; defensive medicine; fear; liability; legal; prescribing behavior; litigation | Document URI: | http://hdl.handle.net/1942/28524 | ISSN: | 0305-7453 | e-ISSN: | 1460-2091 | DOI: | 10.1093/jac/dky098 | ISI #: | 000438375800037 | Rights: | The Author(s) 2018. Published by Oxford University Press on behalf of the British Society for Antimicrobial Chemotherapy. All rights reserved | Category: | A1 | Type: | Journal Contribution |
Appears in Collections: | Research publications |
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OP-JANM180098 1989..1996.pdf Restricted Access | Published version | 324.54 kB | Adobe PDF | View/Open Request a copy |
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