Advanced Search

Journal Navigation

Journal Home

Subscriptions

Archive

Contact Us

Table of Contents

CiteULike is a free service for managing and discovering scholarly references - click here to get started.

Sign In to gain access to subscriptions and/or personal tools.
Medical Decision Making
This Article
Right arrow Full Text (PDF)
Right arrow References
Right arrow Alert me when this article is cited
Right arrow Alert me if a correction is posted
Right arrow Citation Map
Services
Right arrow Email this article to a friend
Right arrow Similar articles in this journal
Right arrow Similar articles in PubMed
Right arrow Alert me to new issues of the journal
Right arrow Add to Saved Citations
Right arrow Download to citation manager
Right arrowRequest Permissions
Right arrow Request Reprints
Right arrow Add to My Marked Citations
Citing Articles
Right arrow Citing Articles via Google Scholar
Right arrow Citing Articles via Scopus
Google Scholar
Right arrow Articles by Metlay, J. P.
Right arrow Articles by Asch, D. A.
Right arrow Search for Related Content
PubMed
Right arrow PubMed Citation
Right arrow Articles by Metlay, J. P.
Right arrow Articles by Asch, D. A.
Social Bookmarking
Add to CiteULike   Add to Complore   Add to Connotea   Add to Del.icio.us   Add to Digg   Add to Reddit   Add to Technorati   Add to Twitter  
What's this?

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

Joshua P. Metlay, MD, PhD

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, PhD

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, MD, MBA

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

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.

Key Words: antibiotics • medical decision making • attitudes of health personnel

Medical Decision Making, Vol. 22, No. 6, 498-505 (2002)
DOI: 10.1177/0272989X02238297
Add to CiteULike CiteULike   Add to Complore Complore   Add to Connotea Connotea   Add to Del.icio.us Del.icio.us   Add to Digg Digg   Add to Reddit Reddit   Add to Technorati Technorati   Add to Twitter Twitter    What's this?