This article is more than 5 years old. Information may no longer be current.
Prescribing etiquette influences antimicrobial prescribing behaviors
Antimicrobial prescribing behaviors are influenced by rules of etiquette that are not defined in clinical guidelines or literature, researchers reported in Clinical Infectious Diseases.
“These rules demonstrate the existence of a ‘prescribing etiquette’ that determines the antimicrobial prescribing behaviors of health care professionals,” Esmita Charani, MPharm, MSc, of the Center for Infection Prevention and Management at Imperial College London, told Infectious Disease News. “In order to influence antimicrobial prescribing behaviors, it is important for organizations to recognize prescribing etiquette as a determinant of antimicrobial prescribing behaviors and address its key points as part of interventions.”
Esmita Charani
Charani and colleagues conducted qualitative, semi-structured interviews with doctors, pharmacists, nurses and midwives at four hospitals.
They identified three key themes. First was decision-making autonomy, where senior doctors rely on their professional judgment and not policies to guide their antimicrobial prescribing. Second, there is a culture of non-interference in which professionals do not question the prescribing behaviors of others, even when these behaviors may counter policy. Last, there is a culture of hierarchy, in which junior doctors adhere to the decisions of senior doctors.
“It was surprising that all health care professionals, regardless of their specialty or profession, demonstrated an understanding of the fundamental etiquette we identified that determines prescribing behaviors,” Charani said. “These data will help inform future studies by generating further research questions and help provide context to interventions in antimicrobial prescribing.”
Charani said they are conducting additional research to test the findings of this study and to identify successful and sustainable interventions to influence antimicrobial prescribing in hospitals.
Esmita Charani, MPharm, MSc, can be reached at e.charani@imperial.ac.uk.
Disclosure: Charani reports no relevant financial disclosures.