Fellow or Postdoc
Dongzhe Hong, Robert Morlock, Joshua P. Metlay, John H Powers, Aaron S. Kesselheim, William B. Feldman
William B. Feldman
The development of new effective antimicrobial therapies has become a key public health priority. To understand factors that guide physician decision-making when prescribing antibiotics for community acquired pneumonia (CAP), uncomplicated urinary tract infections (UTI), and cellulitis, we used a cross-sectional online survey to identify 130 physicians enrolled in an online panel who reported having prescribed antibiotics within the past year. A total of 106 (81.5%) completed the survey. Just under half (45.3%) practiced primarily in inpatient settings, while 54.7% practiced primarily in outpatient settings. Across the 3 infectious diseases, the most important factors identified by physicians when prescribing antibiotics, in order of priority, were cure rate of the antibiotic, severity of patient’s infection, rare but major side effects, interactions with other drugs, and physician’s previous experience and knowledge. Out-of-pocket costs to patients were the least important characteristic across all three diseases. These findings underscore how factors associated with treatment effectiveness (i.e., the cure rate) predominate over other factors in physician decision-making around antibiotic prescribing. Policymakers seeking to incentivize new antibiotic development should be attuned to physician prescribing preferences in order to maximize health benefits for patients.
The development of new effective antibiotics is an important public health priority, as some bacteria can cause infections that are hard to treat with current drugs on market. We wanted to analyze what factors doctors consider important when they choose a drug for their patients who have pneumonia, urinary tract infections, and cellulitis. We surveyed 106 doctors about their prescribing patterns and found that the most important consideration was how well the drug worked to cure the infection. The next most important considerations were how serious the infection was, what other side effects or problems the drug could cause, how the new drug interacted with other drugs, and what doctors knew about the drug from their own experience. The least important factor was the cost for the patients. Our study shows that doctors want to use the best drug possible for their patients who have infections. Policymakers seeking to incentivize new antibiotic development should be attuned to physician prescribing preferences in order to maximize health benefits for patients.