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October 28, 2002 — Although most physicians consider antibiotic resistance a serious national problem, they have different views on its causes, importance and possible solutions. This disparity may hamper efforts to improve antibiotic prescribing, according to an article in the October 28 issue of The Archives of Internal Medicine, a journal of the American Medical Association.
Antibiotic resistance is believed to be caused in part by excessive prescribing of antibiotics, causing the bacteria they are meant to fight to become resistant to the effects of these drugs.
According to background information in the article, the recognition that over prescription of antibiotics can lead to antibiotic resistance, has resulted in a call to reform antibiotic prescription practices. But because changes in antibiotic prescription will require changes in physician behavior, it is important to understand physicians' perceptions of antibiotic prescription as it relates to the problem of resistance.
C. William Wester, M.D., of Cook County Hospital and Rush Medical College in Chicago, and colleagues surveyed 490 internal medicine physicians at four Chicago-area hospitals to assess their attitudes on the importance of antibiotic resistance, knowledge about its prevalence, self-reported experience with antibiotic resistance, beliefs about its causes, and attitudes about interventions designed to address the problem.
Eighty-seven percent of physicians surveyed responded (424 of 490). The researchers found that antibiotic resistance was perceived as a very important national problem by 87 percent of the responders, but only 55 percent rated the problem as very important at their own hospitals. Ninety-seven percent of physicians believed that widespread over prescription of antibiotics was the cause of antibiotic resistance, but only 60 percent favored restricting the use of broad-spectrum antibiotics.
"In summary, the physicians we surveyed were aware of antibiotic resistance as a national problem and recognized the causal role of excessive antibiotic use. At the same time, however, there was substantial ambivalence about the importance of antibiotic resistance in the physicians' own hospitals, the effectiveness of reducing antibiotic consumption in combating resistance, and the importance of poor hand hygiene as a contributor to resistance. These contradictory perspectives present challenges that must be overcome if we are to successfully address the mounting problem of antibiotic resistance."