1Sunshine Coast University Hospital, 6 Doherty Street, Birtinya, QLD 4575
The optimisation of antimicrobial use is critical in the global efforts to slow the development of antimicrobial resistance. And yet overuse persists both in Australia and internationally, including within hospitals. What drives this overuse, and what are the critical influences on antimicrobial decision-making? And how can we potentially use these influences to drive practice change?
Increasing international data demonstrates the influences of social factors in antimicrobial over-use. Data from a range of hospital settings in Australia (remote, regional and metropolitan) identify fear (of adverse outcomes, peer disapproval, and litigation, among others) and hierarchical influence within the hospital system as having a significant impact on antimicrobial prescribing decisions. The strong role of specialty specific leadership and local institutional cultures is also revealed. Cultures of antimicrobial prescribing will have a strong influence on what antimicrobial stewardship strategies are likely to be effective in bringing about sustainable changes in prescribing.