医学
药方
家庭医学
抗生素管理
主题分析
专业
指南
抗菌管理
定性研究
痤疮
长期护理
抗生素
护理部
抗生素耐药性
皮肤病科
病理
微生物学
生物
社会科学
社会学
作者
Ronnie A. Festok,Avni S. Ahuja,Jared Y. Chen,Lena Chu,Jason Barron,Katherine Case,Elaine C. Thompson,Shuo Chen,Jonathan S. Weiss,Robert A. Swerlick,Cam Escoffery,Howa Yeung
标识
DOI:10.1001/jamadermatol.2024.0203
摘要
Dermatologists prescribe more oral antibiotics per clinician than clinicians in any other specialty. Despite clinical guidelines that recommend limitation of long-term oral antibiotic treatments for acne to less than 3 months, there is little evidence to guide the design and implementation of an antibiotic stewardship program in clinical practice.To identify salient barriers and facilitators to long-term antibiotic prescriptions for acne treatment.This qualitative study assessed data collected from stakeholders (including dermatologists, infectious disease physicians, dermatology resident physicians, and nonphysician clinicians) via an online survey and semistructured video interviews between March and August 2021. Data analyses were performed from August 12, 2021, to January 20, 2024.Online survey and qualitative video interviews developed with the Theoretical Domains Framework. Thematic analyses were used to identify salient themes on barriers and facilitators to long-term antibiotic prescriptions for acne treatment.Among 30 participants (14 [47%] males and 16 [53%] females) who completed the study requirements and were included in the analysis, knowledge of antibiotic guideline recommendations was high and antibiotic stewardship was believed to be a professional responsibility. Five salient themes were to be affecting long-term antibiotic prescriptions: perceived lack of evidence to justify change in dermatologic practice, difficulty navigating patient demands and satisfaction, discomfort with discussing contraception, iPLEDGE-related barriers, and the absence of an effective system to measure progress on antibiotic stewardship.The findings of this qualitative study indicate that multiple salient factors affect long-term antibiotic prescribing practices for acne treatment. These factors should be considered in the design and implementation of any future outpatient antibiotic stewardship program for clinical dermatology.
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