Optimizing the usability of hospital antibiograms: A step towards efficient diagnostic stewardship (STRIDE)
This cross-sectional survey identifies key factors influencing clinician use of antibiograms in Ontario hospitals and offers actionable recommendations to improve access, training, and integration into clinical practice.
Background
Background: Our study examines the key barriers and facilitators as perceived by clinicians regarding the use of antibiograms in hospital settings.
Methods: This cross-sectional study involved physicians in Toronto hospitals and pharmacists Ontario-wide that met the inclusion criteria. Data was collected through an online self-administered survey. The primary outcome was factors associated with increased antibiogram usage determined by multivariable logistic regression. Secondary outcomes included a compilation of clinicians’ recommendations for changes to hospital antibiogram format and measures that institutions can take to increase antibiogram use; these recommendations are reported by percentages, frequencies, and weighted mean score.
Results: A total of 149 responses from 123 physicians and 31 pharmacists, were analyzed. Significant independent predictors of antibiogram use included: antibiogram access in institutions (OR 111.11, 95% CI:17.5–1001, p<0.0001), satisfactory training in antibiograms (OR 11.34, 95% CI:2.03–63.29, p=0.008), higher prescription frequency (>5/month) (OR 9.7, 95% CI: 1.39–71.42, p=0.0026), and working in infectious diseases (OR 37.07, 95% 1.65–1001, p=0.023). Recommendations for changes in antibiograms to increase their usability included: developing simple, interactive, digital, colour-coded versions, providing syndrome-specific data, posting antibiograms on a website or mobile apps, providing guidance on usage, integrating antibiograms into electronic health records, coupling antibiograms with treatment guidelines, offering frequent updates and email notification of updates, and requesting feedback via email.
Interpretation: In order to increase antibiograms usage, it is recommended to address key barriers and facilitators noted by clinicians by developing interventions addressing access, education, promotion, updates and notification, and gathering feedback.
Project team
- Ayesha Athar
- Kaitlyn Gosalves
TRP supervisors
Project advisory committee
- Dr. Linda Dresser
- Dr. Derek McFadden
- Dr. Allison McGeer
- Dr. Andrew Morris
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