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Trial Lecture – time and place
See Trial Lecture.
Adjudication committee
- First opponent: Senior Researcher Esmita Charani, Imperial College London, United Kingdom
- Second opponent: Professor Jan Kristian Damås, NTNU - Norwegian University of Science and Technology, Trondheim
- Third member and chair of the evaluation committee: Associate Professor Kristian Tonby, University of Oslo
Chair of the Defence
Professor II Dominique Andree Yvette Caugant, University of Oslo
Principal Supervisor
Senior Consultant Jon Birger Haug, Østfold Hospital Trust, Sarpsborg
Summary
Antimicrobial resistance (AMR) is a global health crisis, effective antimicrobial stewardship (AMS) programs is one tool to combat this looming threat. Tailoring AMS programs to specific contexts is crucial for sustainable mitigation of AMR. Towards tailoring AMS programs, qualitative research plays a key role in identifying unique drivers and barriers.
We have conducted two semi-structured interview studies, exploring factors influencing hospital physicians' antibiotic prescribing decisions and their experiences with procalcitonin (PCT), a blood-based inflammatory marker well documented as an antibiotic decision-aid. Critical barriers to rational antibiotic prescription were time pressure and clinical uncertainty, and the physicians expressed a need for more guidance in effectively using and interpreting PCT results.
As a pivotal aspect of AMS is the optimization of diagnostic tools, we investigated whether PCT could guide antibiotic prescriptions to patients with seasonal influenza. Up to 80% of antibiotic prescriptions are unwarranted, and the role of PCT in this disease has never been investigated.
In a prospective, quantitative study we found that a PCT value below 0.25 µg/L can reliably exclude bacterial co-infection in influenza patients. Additionally, we observed a correlation between PCT levels and antibiotic usage, reinforcing PCT's potential as a valuable AMS tool in seasonal influenza.
We propose several targeted strategies to optimize antibiotic prescribing practices: addressing clinicians' time constraints, enhancing microbiological testing and consultation processes with infectious disease specialists, and implementing PCT as a routine AMS tool for the management of antimicrobial prescripotion in hospitalized patients with seasonal influenza. These measures aim to refine antibiotic usage, aligning with broader AMS objectives.
Additional information
Contact the research support staff.