Implementing antimicrobial stewardship programmes: doctors attitudes

Antimicrobial stewardship programmes are significant in clinical practice to reduce emerging resistance. The aim of this research was to conduct interviews with 28 doctors in Cavan General Hospital in order to explore their attitudes on the barriers and facilitators to implementing antimicrobial stewardship programmes in acute appendicitis. Assisted by an interview schedule, interviews were conducted post ethical approval and informed consent. Data were transcribed and analysed using software designed for qualitative research and the framework method was applied. All data were anonymous, coded and securely stored. Three key themes emerged as barriers to implementation. Theme 1 identified lack of knowledge, experience and confidence as barriers to successful implementation. In Theme 2, disagreement with antimicrobial guidelines by doctors and ineffective communication between the guideline developers and users emerged as the main barriers. Theme 3 identified the presence of contradictory literature resulted in guideline barriers as well as lack of time and resources. The use of a high level of evidence and the involvement of doctors in their development emerged as key facilitators.