Internal Medicine Resident Perspectives Regarding Broad-Spectrum Antibiotic Usage.
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ABSTRACT:
SUBMITTER: Laake AM
PROVIDER: S-EPMC5433385 | biostudies-literature | 2017
REPOSITORIES: biostudies-literature
Publications
Internal Medicine Resident Perspectives Regarding Broad-Spectrum Antibiotic Usage.
Laake Ann M AM Bernabe Gayle G Peterson James J Liappis Angelike P AP
Open forum infectious diseases 20170404 2
Focus groups held with internal medicine residents discussed their perspectives regarding broad-spectrum antibiotic (BSA) usage. Residents knew of BSA-associated adverse events, but they did not associate such events with increased patient morbidity and mortality, and they were more likely to use BSA in situations with diagnostic uncertainty and sick patients. ...[more]
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Project description:IntroductionThe role of outpatient preceptor is a core component of many careers within internal medicine (both general internal medicine and subspecialty practice), yet opportunities to learn and practice this skill during residency training are limited. The purpose of this initiative was to introduce outpatient clinic precepting into the third-year ambulatory experience with a didactic and experiential curriculum.MethodsInternal medicine third-year residents received a 1-hour didactic on outpatient precepting and participated in a precepting session in their ambulatory block rotation during the 2017-2018 academic year. During this session, third-year residents precepted their first- and second-year colleagues in the residency clinic with faculty supervision. Residents were surveyed before the didactic and after the precepting experience to assess precepting comfort level, preparedness to supervise others, and satisfaction with the initiative in the ambulatory curriculum.ResultsA total of 38 third-year residents were eligible to participate in the initiative, and 36 (94%) participated in the precepting session. Survey response rates were 76% and 78% for pre- and postsurveys, respectively. Resident survey scores of self-assessed teaching, precepting, and supervision skills increased from a mean of 25 out of 42 to 34 out of 42 (p < .001), with an average enjoyment score of 10.3 out of a possible 12, suggesting high learner satisfaction.DiscussionThe introduction of outpatient clinic precepting into the third-year internal medicine residency ambulatory curriculum was met with high participation and satisfaction and can be a successful approach to augmenting the outpatient residency experience.
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Project description:Background Antibiotic resistance is a serious public health threat that results mainly secondary to antibiotics misuse. The present study aimed to determine the knowledge, attitude, and practice toward antibiotic use among the Syrian population. Methods This cross-sectional study was conducted at the outpatient clinics of two major hospitals in Damascus, Syria. Applying a random convenience sampling, data were collected in a 1-week period by interviewing participants using a structured questionnaire, which targeted demographics, practice, knowledge, and attitude. Data were used to assess the relationship between the knowledge level and attitudes and demographics. Results Most respondents had a moderate level of knowledge (187, 74.8%) and a moderate attitude score (148, 59.2%). In addition, most respondents (149, 59.6%) stated that they take antibiotics based on pharmacist advice only and do not complete the full antibiotic course (200, 80%). A significant association was found between the knowledge level and financial status ( p -value = 0.003), education level ( p -value = 0.001), and having relatives working in the health care sector ( p -value = 0.021). In addition, a significant association was found between the attitude and having health insurance. Conclusion This study provides baseline evidence about the knowledge, attitudes, and practices regarding antibiotics among the Syrian population, that will help in designing targeted interventions to solve the inappropriate use of antibiotics.
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Project description:Most small molecules are unable to rapidly traverse the outer membrane of Gram-negative bacteria and accumulate inside these cells, making the discovery of much-needed drugs against these pathogens challenging. Current understanding of the physicochemical properties that dictate small-molecule accumulation in Gram-negative bacteria is largely based on retrospective analyses of antibacterial agents, which suggest that polarity and molecular weight are key factors. Here we assess the ability of over 180 diverse compounds to accumulate in Escherichia coli. Computational analysis of the results reveals major differences from the retrospective studies, namely that the small molecules that are most likely to accumulate contain an amine, are amphiphilic and rigid, and have low globularity. These guidelines were then applied to convert deoxynybomycin, a natural product that is active only against Gram-positive organisms, into an antibiotic with activity against a diverse panel of multi-drug-resistant Gram-negative pathogens. We anticipate that these findings will aid in the discovery and development of antibiotics against Gram-negative bacteria.
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