Table 3 Selected quotes surrounding participants experiences and expectations of prescribing antibiotics
No. | Quote | |
|---|---|---|
Expectations of antimicrobial use | ||
1 | “I think I know when would be an easy enough time as a junior doctor to go, yeah, I think this warrants Tazocin, this warrants cefuroxime IV. So for some drugs I think you have a little bit more of an ease of prescribing because you’re not too worried about the downsides” | On-rotation, acute medicine 1 |
2 | “So nights, I think obviously it becomes much more of a zoo doesn’t it really, so people tend to start broad spectrum agents without really looking through previous microbes and patients have a tendency to stay on that till it’s reviewed in daytime hours” | On-rotation, acute medicine 2 |
3 | “If the patient is septic or something, you have to start antibiotics within your hour, Sepsis Six, but then you’re also under pressure to get the right source” | On-rotation, acute medicine 2 |
4 | “Yeah, definitely in terms of how you go but I think anyone who’s done hospital medicine now sees that Tazocin is basically the port of call for most things” | On-rotation, cardiology |
5 | “When I look back at years gone past, I think I was probably quite gung-ho with antibiotics because it was the easy option because you didn’t want to get in trouble and I’m sure plenty of patients in [region - UK] got BenPen [benzylpenicillin] and Cipro [ciprofloxacin] when they might have lived without it. But this is a situation in which, I think, the way I’ve changed is that I tend to look at what the risks of deferring here versus not” | Specialist registrar, cardiology |
6 | “I’ve got a bit of a nice cushion from all the senior levels about even if I prescribe the wrong antibiotic, I don’t mean of course prescribing penicillin when someone’s penicillin allergic, that’s not what I mean. I mean prescribing for example flucloxacillin when it’s an E. coli bacteria, wrong bacteria, wrong antibiotic of choice or bacteria, but an antibiotic nonetheless” | On-rotation, acute medicine 3 |
7 | “I think a lot of people, myself included, would say if you are admitting the patient to hospital and they have an infection severe enough to come into hospital then you should, and I know this is not what microbiologists would say, but in my mind you like to feel like you are doing something that they couldn’t have at home and that’s why you give them some intravenous antibiotics when they come into hospital with a view to stepping them down very quickly afterwards, and I think it makes everyone feel better whether it’s the patient and more significantly the doctor” | Consultant, general internal medicine |
8 | “I would not expect an SHO [senior house officer] to decline to give antibiotics” | Specialist registrar, geriatrics |