UK clinicians' attitudes towards the application of molecular diagnostics to guide antibiotic use in ICU patients with pneumonias: a quantitative study.


Journal

The Journal of antimicrobial chemotherapy
ISSN: 1460-2091
Titre abrégé: J Antimicrob Chemother
Pays: England
ID NLM: 7513617

Informations de publication

Date de publication:
16 Nov 2023
Historique:
received: 25 04 2023
accepted: 13 10 2023
medline: 16 11 2023
pubmed: 16 11 2023
entrez: 16 11 2023
Statut: aheadofprint

Résumé

Molecular diagnostic tests may improve antibiotic prescribing by enabling earlier tailoring of antimicrobial therapy. However, clinicians' trust and acceptance of these tests will determine their application in practice. To examine ICU prescribers' views on the application of molecular diagnostics in patients with suspected hospital-acquired and ventilator-associated pneumonia (HAP/VAP). Sixty-three ICU clinicians from five UK hospitals completed a cross-sectional questionnaire between May 2020 and July 2020 assessing attitudes towards using molecular diagnostics to inform initial agent choice and to help stop broad-spectrum antibiotics early. Attitudes towards using molecular diagnostics to inform initial treatment choices and to stop broad-spectrum antibiotics early were nuanced. Most (83%) were positive about molecular diagnostics, agreeing that using results to inform broad-spectrum antibiotic prescribing is good practice. However, many (58%) believed sick patients are often too unstable to risk stopping broad-spectrum antibiotics based on a negative result. Positive attitudes towards the application of molecular diagnostics to improve antibiotic stewardship were juxtapositioned against the perceived need to initiate and maintain broad-spectrum antibiotics to protect unstable patients.

Sections du résumé

BACKGROUND BACKGROUND
Molecular diagnostic tests may improve antibiotic prescribing by enabling earlier tailoring of antimicrobial therapy. However, clinicians' trust and acceptance of these tests will determine their application in practice.
OBJECTIVES OBJECTIVE
To examine ICU prescribers' views on the application of molecular diagnostics in patients with suspected hospital-acquired and ventilator-associated pneumonia (HAP/VAP).
METHODS METHODS
Sixty-three ICU clinicians from five UK hospitals completed a cross-sectional questionnaire between May 2020 and July 2020 assessing attitudes towards using molecular diagnostics to inform initial agent choice and to help stop broad-spectrum antibiotics early.
RESULTS RESULTS
Attitudes towards using molecular diagnostics to inform initial treatment choices and to stop broad-spectrum antibiotics early were nuanced. Most (83%) were positive about molecular diagnostics, agreeing that using results to inform broad-spectrum antibiotic prescribing is good practice. However, many (58%) believed sick patients are often too unstable to risk stopping broad-spectrum antibiotics based on a negative result.
CONCLUSIONS CONCLUSIONS
Positive attitudes towards the application of molecular diagnostics to improve antibiotic stewardship were juxtapositioned against the perceived need to initiate and maintain broad-spectrum antibiotics to protect unstable patients.

Identifiants

pubmed: 37970680
pii: 7424367
doi: 10.1093/jac/dkad355
pii:
doi:

Types de publication

Journal Article

Langues

eng

Sous-ensembles de citation

IM

Subventions

Organisme : National Institute for Health Research
ID : RP-PG-0514-493 20018

Investigateurs

Julie A Barber (JA)
Zaneeta Dhesi (Z)
Laura Shallcross (L)
Justin O'Grady (J)
Juliet High (J)
David Turner (D)
Valerie Page (V)
Hala Kandil (H)
Robert Parker (R)
Daniel Martin (D)
Damien Mack (D)
Emmanuel Q Wey (EQ)
Tom W Reader (TW)
Deborah Smyth (D)

Informations de copyright

© The Author(s) 2023. Published by Oxford University Press on behalf of British Society for Antimicrobial Chemotherapy.

Auteurs

Sarah-Jane F Stewart (SF)

Centre for Behavioural Medicine, University College London, London, UK.

Alyssa M Pandolfo (AM)

Centre for Behavioural Medicine, University College London, London, UK.

Zoe Moon (Z)

Centre for Behavioural Medicine, University College London, London, UK.

Yogini Jani (Y)

Centre for Behavioural Medicine, University College London, London, UK.
UCLH-UCL Centre for Medicines Optimisation Research and Education, University College London Hospitals NHS Foundation Trust, London, UK.

Stephen J Brett (SJ)

Department of Surgery and Cancer, Imperial College London, London, UK.

David Brealey (D)

Division of Critical Care, University College London Hospitals NHS Foundation Trust, London, UK.

Suveer Singh (S)

Department of Respiratory and Critical Care Medicine, Chelsea and Westminster Hospital NHS Foundation Trust, London, UK.
Faculty of Medicine, Imperial College London, London, UK.

Virve I Enne (VI)

Division of Infection and Immunity, University College London, London, UK.

David M Livermore (DM)

Norwich Medical School, University of East Anglia, Norwich, Norfolk, UK.

Vanya Gant (V)

Department of Medical Microbiology, University College London Hospitals NHS Foundation Trust, London, UK.

Robert Horne (R)

Centre for Behavioural Medicine, University College London, London, UK.

Classifications MeSH