Bojana Beović1,2, May Doušak3, Céline Pulcini4,5, Guillaume Béraud6,7,8, Jose Ramon Paño Pardo9,10, David Sánchez-Fabra9,10, Diamantis Kofteridis11, Joana Cortez12, Leonardo Pagani13, Maša Klešnik1, Kristina Nadrah1, Mitja Hafner Fink3, Dilip Nathwani14, Samo Uhan3. 1. University Medical Centre Ljubljana, Ljubljana, Slovenia. 2. Faculty of Medicine, University of Ljubljana, Ljubljana, Slovenia. 3. Faculty of Social Sciences, University of Ljubljana, Ljubljana, Slovenia. 4. Université de Lorraine, APEMAC, Nancy, France. 5. CHRU-Nancy, Infectious Diseases Department, Nancy, France. 6. University Hospital of Poitiers, Poitiers, France. 7. Santé des populations et pratiques optimales en santé University Hospital of Québec-Laval University Research Center, Canada. 8. EA 2694 Lille University, Lille, France. 9. Hospital Clínico Universitario Lozano Blesa, Zaragoza, Spain. 10. IIS Aragón, Zaragoza, Spain. 11. University Hospital of Heraklion, Heraklion, Crete, Greece. 12. Bolzano Central Hospital, Bolzano, Italy. 13. Integrated Programme for the Reduction of Maternal and Child Mortality, Instituto Marquês de Valle Flôr, Bissau, Guinea-Bissau. 14. University of Dundee, Ninewells Hospital and Medical School, Dundee, UK.
Abstract
BACKGROUND: Postgraduate training has the potential to shape the prescribing practices of young doctors. OBJECTIVES: To investigate the practices, attitudes and beliefs on antibiotic use and resistance in young doctors of different specialties. METHODS: We performed an international web-based exploratory survey. Principal component analysis (PCA) and bivariate and multivariate [analysis of variance (ANOVA)] analyses were used to investigate differences between young doctors according to their country of specialization, specialty, year of training and gender. RESULTS: Of the 2366 participants from France, Greece, Italy, Portugal, Slovenia and Spain, 54.2% of young doctors prescribed antibiotics predominantly as instructed by a mentor. Associations between the variability of answers and the country of training were observed across most questions, followed by variability according to the specialty. Very few differences were associated with the year of training and gender. PCA revealed five dimensions of antibiotic prescribing culture: self-assessment of knowledge, consideration of side effects, perception of prescription patterns, consideration of patient sickness and perception of antibiotic resistance. Only the country of specialization (partial η2 0.010-0.111) and the type of specialization (0.013-0.032) had a significant effect on all five identified dimensions (P < 0.01). The strongest effects were observed on self-assessed knowledge and in the perception of antibiotic resistance. CONCLUSIONS: The country of specialization followed by the type of specialization are the most important determinants of young doctors' perspectives on antibiotic use and resistance. The inclusion of competencies in antibiotic use in all specialty curricula and international harmonization of training should be considered.
BACKGROUND: Postgraduate training has the potential to shape the prescribing practices of young doctors. OBJECTIVES: To investigate the practices, attitudes and beliefs on antibiotic use and resistance in young doctors of different specialties. METHODS: We performed an international web-based exploratory survey. Principal component analysis (PCA) and bivariate and multivariate [analysis of variance (ANOVA)] analyses were used to investigate differences between young doctors according to their country of specialization, specialty, year of training and gender. RESULTS: Of the 2366 participants from France, Greece, Italy, Portugal, Slovenia and Spain, 54.2% of young doctors prescribed antibiotics predominantly as instructed by a mentor. Associations between the variability of answers and the country of training were observed across most questions, followed by variability according to the specialty. Very few differences were associated with the year of training and gender. PCA revealed five dimensions of antibiotic prescribing culture: self-assessment of knowledge, consideration of side effects, perception of prescription patterns, consideration of patient sickness and perception of antibiotic resistance. Only the country of specialization (partial η2 0.010-0.111) and the type of specialization (0.013-0.032) had a significant effect on all five identified dimensions (P < 0.01). The strongest effects were observed on self-assessed knowledge and in the perception of antibiotic resistance. CONCLUSIONS: The country of specialization followed by the type of specialization are the most important determinants of young doctors' perspectives on antibiotic use and resistance. The inclusion of competencies in antibiotic use in all specialty curricula and international harmonization of training should be considered.