Housestaff focus groups and surveys to determine knowledge, attitudes, and beliefs concerning antibiotic use at The Johns Hopkins Hospital
PI: Arjun Srinivasan, MD
Sponsor: The Centers for Disease Control and Prevention (CDC)

There is widespread agreement that the growing problem of antimicrobial resistance is an important challenge to healthcare. Data from the Centers for Disease Control and Prevention’s (CDC) National Nosocomial Infection Surveillance (NNIS) system indicate that not only have the rates of bacterial resistance risen steadily over the past decade but that this resistance is no longer a phenomenon limited to the intensive care unit (ICU) setting. It has been demonstrated that a great deal of antimicrobial use is either unnecessary or inappropriate and that decreasing this use is effective in curtailing resistance. These facts have prompted many to call for improvements in antimicrobial prescribing practices and have led to the creation of position statements and guidelines from national infectious disease organizations. More recently, the CDC has included several measures pertaining to improved antimicrobial use in its Campaign to Prevent Antimicrobial Resistance in healthcare settings.

Because changes in antimicrobial prescribing patterns will necessitate changes in physician behavior, it is important to better understand what physicians know about antimicrobials, how they acquire and maintain that knowledge and what factors influence their prescribing of antimicrobials. As is the case with other campaigns targeting physician behavior, a better understanding of these underlying factors will permit the development of more effective interventions. Previous surveys have been done to assess both physician knowledge about antimicrobials and attitudes concerning antimicrobial use and resistance. However, only the study by Wester et al. focused on physicians who primarily care for in-patients and included housestaff physicians, although that study focused exclusively on internal medicine residents. No previous physician surveys on antimicrobial use and resistance have included a direct knowledge assessment of antimicrobial use or included housestaff physicians on services other than internal medicine.

We surveyed housestaff physicians from five departments in our hospital to measure their knowledge, attitudes and beliefs about antimicrobial use and resistance and to learn more about how they acquire and maintain their knowledge.