“Nudging” in microbiological reports: a strategy to improve prescribing

Excerpt

Inappropriate antimicrobial use is a global public health issue contributing to the emergence of multidrug resistance [1, 2]. Many strategies to reduce antimicrobial use have been developed. Education of physicians by direct confrontation concerning antimicrobial prescribing errors does not seem to address the psychological causes of inappropriate use and generally has not resulted in sustained reductions in antimicrobial prescriptions [3]. As Charani and colleagues pointed out, prescribing etiquette drives inappropriate use through three mechanisms: non-interference with the prescribing decisions of colleagues; non-compliance of senior staff to antimicrobial prescribing policy is widely accepted; and hierarchy of prescribing, with most senior, but not necessarily most informed, staff conveying prescriptions to junior doctors [4]. Hence, introducing guidelines, policies, and restrictive regulations does not lead automatically to better prescribing practice. …