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Antibiotic Prescribing Decisions of Generalists and Infectious Disease Specialists: Thresholds for Adopting New Drug Therapies

Author

Listed:
  • Joshua P. Metlay

    (Center for Health Equity Research and Promotion, Department of Veterans Affairs, and the Division of General Internal Medicine, the Center for Clinical Epidemiology and Biostatistics, and the Leonard Davis Institute of Health Economics, University of Pennsylvania, Philadelphia)

  • Judy A. Shea

    (Center for Health Equity Research and Promotion, Department of Veterans Affairs, and the Division of General Internal Medicine, the Center for Clinical Epidemiology and Biostatistics, and the Leonard Davis Institute of Health Economics, University of Pennsylvania, Philadelphia)

  • David A. Asch

    (Center for Health Equity Research and Promotion, Department of Veterans Affairs, and the Division of General Internal Medicine, the Center for Clinical Epidemiology and Biostatistics, and the Leonard Davis Institute of Health Economics, University of Pennsylvania, Philadelphia)

Abstract

The objective of this study was to examine whether physicians are willing to continue to use older antibiotics in the face of drug resistance in order to preserve newer antibiotics for future use. The study was a national sample of 398 generalist physicians and 429 infectious disease (ID) specialists. Clinical vignettes prompted respondents to select the level of resistance to a hypothetical older antibiotic at which they would prefer a newer antibiotic without any current resistance in the treatment of a patient with pneumococcal pneumonia. Vignettes varied in the site of care of the patient as a proxy for variation in disease severity. Respondents significantly reduced their threshold for switching to a newer antibiotic as disease severity increased. Generalists were more responsive to disease severity than ID specialists. Thus, the adoption of recommendations to limit overuse of newer antibiotics may be variable across clinical settings and providers, reducing the impact of these recommendations on emerging resistance.

Suggested Citation

  • Joshua P. Metlay & Judy A. Shea & David A. Asch, 2002. "Antibiotic Prescribing Decisions of Generalists and Infectious Disease Specialists: Thresholds for Adopting New Drug Therapies," Medical Decision Making, , vol. 22(6), pages 498-505, December.
    • Handle: RePEc:sae:medema:v:22:y:2002:i:6:p:498-505
    DOI: 10.1177/0272989X02238297
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