Cultural and Economic Factors That (Mis)Shape Antibiotic Use: The Nonpharmacologic Basis of Therapeutics

摘要: The use of antibiotics in both ambulatory and inpatient settings is heavily shaped by cultural economic factors as well microbiological considerations. These nonpharmacologic are relevant to clinicians policymakers because the clinical fiscal toll inappropriate antibiotic prescribing, including excessive use, preventable adverse effects, increasing prevalence resistant organisms. An understanding determinants consumption critical explain current patterns devise programs reduce use. Patient motivations include desire for a tangible product encounter coupled with incorrect perceptions effectiveness antibiotics, particularly viral infections. Physician behavior can be explained such lack information, satisfy patient demand, pressure from managed care organizations speed throughput. Marketing campaigns directed at physicians patients further serve increase especially newer, costlier products. Studies outpatient consistently demonstrate considerable which likely exacerbate emergence Several approaches have been shown improve rationality Computer-based algorithms or reminders prompt choices time prescribing; paper-based order entry forms achieve same goal. Interactive educational outreach ("academic detailing") practical implementation social marketing principles Public education consumers help demand that helps drive much improper prescribing.